Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T15:30:15.982Z Has data issue: false hasContentIssue false

Critical appraisal of questionnaires to assess functional impairment in individuals with mild cognitive impairment

Published online by Cambridge University Press:  13 April 2016

Navaldeep Kaur*
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
Patricia Belchior
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
Isabelle Gelinas
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
Nathalie Bier
Affiliation:
Centre de recherche de l'Institut de gériatrie de Montréal, Montreal, Quebec, Canada
*
Correspondence should be addressed to: Navaldeep Kaur, School of Physical and Occupational Therapy, 3654 prom Sir-William-Osler, Montréal, QC H3G 1Y5, Canada. Phone: (514) 398 4400 ext 00675; Fax: (514) 398-8193. Email: navaldeep.kaur@mail.mcgill.ca.

Abstract

Background:

Mild deficits in instrumental activities of daily living (IADLs) have consistently been reported in the individuals with mild cognitive impairment (MCI). A variety of functional assessment tools, including self-and informant report questionnaires and performance-based measures, have been employed in MCI. Previously, a limited focus has been directed at appraising the quality of questionnaires. The goal of this study was to identify the questionnaires that have been validated in the MCI population. Additionally, the quality of validation studies and psychometric attributes of these questionnaires were appraised.

Methods:

Relevant articles were systematically searched in PsychINFO, Ovid MEDLINE, and CINAHL against specific eligibility criteria. To evaluate the methodology of the psychometric studies, the COSMIN checklist was employed. Also, the psychometric properties of the assessment tools were evaluated based upon Terwee's criteria.

Results:

A total of five psychometric studies and questionnaires were critically evaluated. Varying psychometric properties were available for the chosen tools. None of the studies received the best possible rating for their methodological quality. It was found that questionnaires with high discriminative ability to distinguish MCI from other diagnostic groups were: Disability Assessment in Dementia-6 (DAD-6), Functional Activity Questionnaire (FAQ), and Alzheimer's Disease Cooperative Study/Activities of Daily Living scale adapted for MCI patients (ADCS-MCI-ADL-24).

Conclusion:

Psychometric studies with strong methodological rigor are required in the future. Considering the fact that IADL decline has been associated with dementia, early detection of functional difficulties in MCI needs to be encouraged as it will allow suitable and timely interventions to prolong functional independence of affected individuals.

Type
Review Article
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahn, I. S. et al. (2009). Impairment of instrumental activities of daily living in patients with mild cognitive impairment. Psychiatry Investigation, 6, 180184.Google Scholar
Artero, S., Touchon, J. and Ritchie, K. (2001). Disability and mild cognitive impairment: a longitudinal population-based study. International Journal of Geriatric Psychiatry, 16, 10921097. doi: 10.1002/gps.477.Google Scholar
Belchior, P. C. et al. (2015). Performance-based tools for assessing functional performance in individuals with mild cognitive impairment. The Open Journal of Occupational Therapy, 3, 3.Google Scholar
Burton, C. L., Strauss, E., Bunce, D., Hunter, M. A. and Hultsch, D. F. (2009). Functional abilities in older adults with mild cognitive impairment. Gerontology , 55, 570581. doi: 10.1159/000228918.CrossRefGoogle ScholarPubMed
de Rotrou, J. et al. (2012). DAD-6: A 6-ltem version of the disability assessment for dementia scale which may differentiate Alzheimer's disease and mild cognitive impairment from controls. Dementia and Geriatric Cognitive Disorders, 33, 210218. doi: 10.1159/000338232.Google Scholar
de Vriendt, P., Gorus, E., Cornelis, E., Bautmans, I., Petrovic, M. and Mets, T. (2013). The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment. Journal of Nutrition Health Aging, 17, 6471. doi: 10.1007/s12603-012-0381-9.CrossRefGoogle ScholarPubMed
Farias, S. T., Mungas, D. and Jagust, W. (2006). Degree of discrepancy between self and other-reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy elders. International Journal of Geriatric Psychiatry, 20, 827834. doi: 10.1002/gps.1367.CrossRefGoogle Scholar
Farias, S. T. et al. (2008). The measurement of everyday cognition (ECog): scale development and psychometric properties. Neuropsychology, 22, 531544. doi:10.1037/0894-4105.22.4.531.Google Scholar
Farias, S. T. et al. (2009). Longitudinal changes in memory and executive functioning are associated with longitudinal change in instrumental activities of daily living in older adults. The Clinical Neuropsychologist, 23, 446461. doi:10.1080/13854040802360558.Google Scholar
Fieo, R., Manly, J. J., Schupf, N. and Stern, Y. (2013). Functional status in the young-old: establishing a working prototype of an extended instrumental activities of daily living scale. The Journal of Gerontology A Biological Sciences and Medical Sciences, 69, 766772. doi: 10.1093/gerona/glt167.Google Scholar
Gelinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. American Journal of Occupational Therapy, 53, 471481.Google Scholar
Giovannetti, T. et al. (2008). Characterization of everyday functioning in mild cognitive impairment: a direct assessment approach. Dementia and Geriatric Cognitive Disorders, 25, 359365. doi: 10.1159/000121005.Google Scholar
Gold, D. A. (2012). An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment. Journal of Clinical and Experimental Neuropsychology, 34, 1134. doi: 10.1080/13803395.2011.614598.CrossRefGoogle ScholarPubMed
Hedman, A., Nygard, L., Kottorp, A. and Almkvisit, O. (2013). Patterns of functioning in older adults with mild cognitive impairment: a two-year study focusing on everyday technology use. Aging and Mental Health, 17, 679688.Google Scholar
Hindmarch, I., Lehfeld, H., de Jong, P. and Erzigkeit, H. (1998). The bayer activities of daily living (BADL) scale. Dementia and Geriatric Cognitive Disorders, 9 (Suppl. 2), 2026.Google Scholar
Jefferson, A. L. et al. (2008). Characterization of activities of daily living in individuals with mild cognitive impairment. American Journal of Geriatric Psychiatry, 16, 375383. doi: 10.1097/JGP.0b013e318162f197.CrossRefGoogle ScholarPubMed
Jorm, A. F., Christensen, H., Henderson, A. S., Korten, A. E., Mackinnon, A. J. and Scott, R. (1994). Complaints of cognitive decline in the elderly: a comparison of reports by subjects and informants in a community survey. Psychological Medicine, 24, 365374. doi: 10.1017/S0033291700027343.Google Scholar
Luck, T. et al. (2010). Mild cognitive impairment: incidence and risk factors: results of the leipzig longitudinal study of the aged. Journal of the American Geriatrics Society, 58, 19031910. doi: 10.1111/j.1532-5415.2010.03066.x.Google Scholar
Mariani, E., Monastero, R. and Mecocci, P. (2007). Mild cognitive impairment: a systematic review. Journal of Alzheimer's Disease, 12, 2335.Google Scholar
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. and The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6, e1000097. doi:10.1371/journal.pmed.1000097.CrossRefGoogle ScholarPubMed
Mokkink, L. B. et al. (2010a). The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Quality of Life Research, 19, 539549. doi:10.1007/s11136-010-9606-8.Google Scholar
Mokkink, L. B. et al. (2010b). The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology, 63, 737745. doi: 10.1016/j.jclinepi.2010.02.006.Google Scholar
Njegovan, V., Hing, M. M., Mitchell, S. L. and Molnar, F. J. (2001). The hierarchy of functional loss associated with cognitive decline in older persons. Journal of Gerontology A: Biological Sciences and Medical Sciences, 56, M638–M643.Google Scholar
Nygard, L., Pantzar, M., Uppgard, B. and Kottorp, A. (2012). Detection of activity limitations in older adults with MCI or Alzheimer's disease through evaluation of perceived difficulty in use of everyday technology: A replication study. Aging & Mental Health, 16, 361371.Google Scholar
Pedrosa, H. et al. (2010). Functional evaluation distinguishes MCI patients from healthy elderly people – the ADCS/MCI/IADL Scale. The Journal of Nutrition, Health & Aging, 14, 703709. doi: 10.1007/s12603-010-0102-1.Google Scholar
Perneczky, R. et al. (2006a). Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. International Journal of Geriatric Psychiatry, 21, 158162. doi: 10.1002/gps.1444.CrossRefGoogle ScholarPubMed
Perneczky, R. et al. (2006b). Complex activities of daily living in mild cognitive impairment: Conceptual and diagnostic issues. Age Ageing, 35, 240245.Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194. doi: 10.1111/j.1365-2796.2004.01388.x.Google Scholar
Petersen, R. C., Caracciolo, B., Brayne, C., Gauthier, S. and Jelic, V. (2014). Mild cognitive impairment: a concept in evolution (Key Symposium). Journal of Internal Medicine, 275, 214228. doi: 10.1111/joim.12190.Google Scholar
Petersen, R. C. and Morris, J. C. (2005). Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 11601163.Google Scholar
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 19851992.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303308.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H. Jr, Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323329. doi: 10.1093/geronj/37.3.323.Google Scholar
Portet, F. et al. (2006). MCI working group of the European consortium on Alzheimer's disease (EADC). MCI in medical practice: a critical review of the concept and new diagnostic procedure. Report of the mild cognitive impairment working group of the EADC. Journal of Neurology Neurosurgery & Psychiatry, 77, 714718. doi: 10.1136/jnnp.2005.085332.CrossRefGoogle Scholar
Reppermund, S. et al. (2011). The relationship of neuropsychological function to instrumental activities of daily living in mild cognitive impairment. International Journal of Geriatric Psychiatry, 26, 843852. doi: 10.1002/gps.2612.CrossRefGoogle ScholarPubMed
Swets, J. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 12851293.CrossRefGoogle ScholarPubMed
Tabert, M. H. et al. (2002). Functional deficits in patients with mild cognitive impairment: prediction of AD. Neurology, 58, 758764.Google Scholar
Teng, E., Becker, B., Woo, E., Knopman, D. S., Cummings, J. L. and Lu, P. H. (2010). Utility of the functional activities questionnaire for distinguishing mild cognitive impairment from very mild Alzheimer disease. Alzheimer's Disease & Associated Disorders, 24, 348353. doi: 10.1097/WAD.0b013e3181e2fc84.Google Scholar
Terwee, C. B., Mokkink, L. B., Knol, D. L., Ostelo, R. W. J. G., Bouter, L. M. and de Vet, H. C. W. (2012). Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Quality of Life Research, 21, 651657. doi:10.1007/s11136-011-9960-1.Google Scholar
Terwee, C. B. et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 3442. doi: 10.1016/j.jclinepi.2006.03.012.CrossRefGoogle ScholarPubMed
Winblad, B. et al. (2004). Mild cognitive impairment—beyond controversies, towards a consensus: Report of the international working group on mild cognitive impairment. Journal of Internal Medicine, 256, 240246. doi: 10.1111/j.1365-2796.2004.01380.x.Google Scholar
Wolff, J. L. and Roter, D. L. (2008). Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Archives of Internal Medicine, 168, 14091415. doi: 10.1001/archinte.168.13.1409.Google Scholar
World Health Organization. (2001). International Classification of Functioning, Disability and Health, Geneva. Available at: http://www.who.int/classifications/icf/en/; last accessed 30th May 2014.Google Scholar