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Instrumental activities of daily living and mild cognitive impairment

David J Libon1,2, Sheina Emrani3, Emily F Matusz4

  • 1Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, Rowan University-School of Osteopathic Medicine, Stratford, USA.

Journal of Clinical and Experimental Neuropsychology
|August 25, 2023
PubMed
Abstract

Insights

Mild cognitive impairment (MCI) can affect daily functioning. Dysexecutive MCI is linked to greater functional impairment, particularly in managing finances and memory, compared to cognitively normal individuals.

Area of Science:

  • Neuropsychology
  • Gerontology
  • Cognitive Science

Background:

  • Dementia diagnosis requires cognitive and functional impairments.
  • Mild cognitive impairment (MCI) typically presents with relatively intact functional abilities.
  • Distinguishing between cognitive normality and MCI is crucial for early intervention.

Purpose of the Study:

  • To investigate the relationship between cognitive status (cognitively normal, amnestic MCI, dysexecutive MCI) and functional abilities using the Instrumental Activities of Daily Living - Compensation Scale (IADL-C).
  • To explore the association between informant-rated functional abilities (IADL-C) and performance on neuropsychological tests.

Main Methods:

  • 100 memory clinic participants were classified as cognitively normal (CN), amnestic MCI (aMCI), or mixed/dysexecutive MCI (mixed/dys MCI).
  • Participants completed a comprehensive neuropsychological assessment.
  • The IADL-C, an informant-based questionnaire, was used to quantify functional abilities.

Main Results:

  • The mixed/dys MCI group showed significantly greater functional impairment on the IADL-C compared to the CN group.
  • Specific IADL-C subscales, including Money and Self-Management and Travel and Event Memory, were lower in the mixed/dys MCI group.
  • Regression analyses revealed that lower executive function and episodic memory test scores were associated with greater functional impairment.

Conclusions:

  • Functional impairment, as measured by the IADL-C, is disproportionately linked to dysexecutive difficulties in MCI.
  • Episodic memory deficits also contribute to functional impairment, though to a lesser extent.
  • These findings highlight the importance of assessing functional abilities in individuals with MCI, particularly those with executive dysfunction.
Keywords:
ADL abilitiesIADL abilitiesexecutive controlmild cognitive impairmentsubtle cognitive impairment

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