[Cognitive impairment/dementia: assessment and follow-up. Functional aspects]

The importance of functional status is increasingly being recognized in current clinical management. This is especially important in mild cognitive impairment (MCI), which is a priority due to its direct relationship with dementia and awareness that functional alterations are what separates MCI from dementia. Adequate assessment of MCI during the follow-up of this condition allows identification of its progress, whether towards normal cognitive function or detection and diagnosis of the incipient stages of dementia, thus providing the benefits of early diagnosis. This article describes assessment tools for this condition, beginning with performance tests as an objective measure of mobility, followed by measurement of activities of daily living (ADL): advanced, instrumental and basic, with emphasis on the Sydney Test of Activities of Daily Living in Memory Disorders (STAM) and Mongil's tests of activities of daily living. Patient follow-up is essential and should combine assessment of performance tests and ADL measurement. Emphasis is placed on functional status not only because of its association with MCI but also because it has become a therapeutic target and an outcomes indicator.