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Cognitive and neuroimaging predictors of instrumental activities of daily living

  • DEBORAH A. CAHN-WEINER (a1), SARAH TOMASZEWSKI FARIAS (a2), LAURA JULIAN (a3), DANIELLE J. HARVEY (a4), JOEL H. KRAMER (a1), BRUCE R. REED (a2) (a5), DAN MUNGAS (a2), MARGARET WETZEL (a1) and HELENA CHUI (a6)...
Abstract

Impaired ability to conduct daily activities is a diagnostic criterion for dementia and a determinant of healthcare services utilization and caregiver burden. What predicts decline in instrumental activities of daily living (IADLs) is not well understood. This study examined measures of episodic memory, executive function, and MRI brain volumes in relation to baseline IADLs and as predictors of rate of IADL change. Participants were 124 elderly persons with cognitive function between normal and moderate dementia both with and without significant small vessel cerebrovascular disease. Random effects modeling showed that baseline memory and executive function (EXEC) were associated with baseline IADL scores, but only EXEC was independently associated with rate of change in IADLs. Whereas hippocampal and cortical gray matter volumes were significantly associated with baseline IADL scores, only hippocampal volume was associated with IADL change. In a model including cognitive and neuroimaging predictors, only EXEC independently predicted rate of decline in IADL scores. These findings indicate that greater executive dysfunction at initial assessment is associated with more rapid decline in IADLs. Perhaps executive function is particularly important with respect to maintaining IADLs. Alternatively, executive dysfunction may be a sentinel event indicating widespread cortical involvement and poor prognosis. (JINS, 2007, 13, 747–757.)

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Corresponding author
Correspondence and reprint requests to: Deborah Cahn-Weiner, Ph.D., University of California, San Francisco, Department of Neurology, 400 Parnassus Avenue, San Francisco, CA 94143-0138. E-mail: Deborah.Cahn-Weiner@ucsf.edu
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Alexopoulos, P., Grimmer, T., Perneczky, R., Domes, G., & Kurz, A. (2006). Progression to dementia in clinical subtypes of mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 22, 2734.

Barberger-Gateau, P. & Fabrigoule, C. (1997). Disability and cognitive impairment in the elderly. Disability and Rehabilitation, 19, 175193.

Barker, W.W., Luis, C.A., Kashuba, A., Luis, M., Harwood, D.G., Loewenstein, D., Waters, C., Jimison, P., Shepherd, E., Sevush, S., Graff-Radford, N., Newland, D., Todd, M., Miller, B., Gold, M., Heilman, K., Doty, L., Goodman, I., Robinson, B., Pearl, G., Dickson, D., & Duara, R. (2002). Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer's Disease and Associated Disorders, 16, 203212.

Bell-McGinty, S., Podell, K., Franzen, M., Baird, A.D., & Williams, M.J. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17, 828834.

Bennett, H.P., Corbett, A.J., Gaden, S., Grayson, D.A., Kril, J.J., & Broe, G.A. (2002). Subcortical vascular disease and functional decline: A 6-year predictor study. Journal of the American Geriatric Society, 50, 19691977.

Blessed, G., Tomlinson, B.E., & Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797811.

Boyle, P.A., Cohen, R.A., Paul, R., Moser, D., & Gordon, N. (2002). Cognitive and motor impairments predict functional declines in patients with vascular dementia. International Journal of Geriatric Psychiatry, 17, 164169.

Boyle, P.A., Paul, R.H., Moser, D.J., & Cohen, R.A. (2004). Executive impairments predict functional declines in vascular dementia. The Clinical Neuropsychologist, 18, 7582.

Braak, H. & Braak, E. (1991). Neuropathological staging of Alzheimer-related changes. Acta Neuropathologica, 82, 239259.

Cahn, D.A., Sullivan, E.V., Shear, P.K., Pfefferbaum, A., Heit, G., & Silverberg, G. (1998). Differential contributions of cognitive and motor component processes to physical and instrumental activities of daily living in Parkinson's disease. Archives of Clinical Neuropsychology, 13, 575583.

Christensen, G.E., Joshi, S.C., & Miller, M.I. (1997). Volumetric transformation of brain anatomy. IEEE Trans Med Imaging, 16, 864877.

Chui, H.C., Victoroff, J.I., Margolin, D., Jagust, W., Shankle, R., & Katzman, R. (1992). Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology, 42, 473480.

Cummings, J.L. (1993). Frontal-subcortical circuits and human behavior. Archives of Neurology, 50, 873880.

DeCarli, C., Mungas, D., Harvey, D., Reed, B., Weiner, M., Chui, H., & Jagust, W. (2004). Memory impairment, but not cerebrovascular disease, predicts progression of MCI to dementia. Neurology, 63, 220227.

Farias, S.T., Mungas, D., Reed, B., Haan, M.N., & Jagust, W.J. (2004). Everyday functioning in relation to cognitive functioning and neuroimaging in community-dwelling Hispanic and non-Hispanic older adults. Journal of the International Neuropsychological Society, 10, 342354.

Fein, G., Di Sclafani, V., Tanabe, J., Cardenas, V., Weiner, M.W., Jagust, W.J., Reed, B.R., Norman, D., Schuff, N., Kusdra, L., Greenfield, T., & Chui, H. (2000). Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease. Neurology, 55, 16261635.

Feldman, H., Sauter, A., Donald, A., Gelinas, I., Gauthier, S., Torfs, K., Parys, W., & Mehnert, A. (2001). The Disability Assessment for Dementia Scale: A 12-month study of functional ability in mild to moderate severity Alzheimer disease. Alzheimer Disease and Associated Disorders, 15, 8995.

Griffith, H.R., Belue, K., Sicola, A., Krzywanski, S., Zamrini, E., Harrell, L., & Marson, D.C. (2003). Impaired financial abilities in mild cognitive impairment: A direct assessment approach. Neurology, 60, 449457.

Hope, T., Keene, J., Gedling, K., Fairburn, C.G., & Jacoby, R. (1998). Predictors of institutionalization for people with dementia living at home with a carer. International Journal of Geriatric Psychiatry, 13, 682690.

Hsu, Y.Y., Schuff, N., Amend, D.L., Du, A.T., Norman, D., Chui, H.C., Jagust, W.J., & Weiner, M.W. (2002). Quantitative magnetic resonance imaging differences between Alzheimer disease with and without subcortical lacunes. Alzheimer's Disease and Associated Disorders, 16, 5864.

Hughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140, 566572.

Hyman, B.T., Van Hoesen, G.W., Damasio, A.R., & Barnes, C.L. (1984). Alzheimer's disease: Cell-specific pathology isolates the hippocampal formation. Science, 225, 11681170.

Korf, E.S., Wahlund, L.O., Visser, P.J., & Scheltens, P. (2004). Medial temporal lobe atrophy on MRI predicts dementia in patients with mild cognitive impairment. Neurology, 63, 94100.

Laird, N.M. & Ware, J.H. (1982). Random-effects models for longitudinal data. Biometrics, 38, 963974.

McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.

Meyer, J., Xu, G., Thornby, J., Chowdhury, M., & Quach, M. (2002). Longitudinal analysis of abnormal domains comprising mild cognitive impairment (MCI) during aging. Journal of the Neurological Sciences, 201, 1925.

Morris, J.C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43, 24122414.

Mungas, D., Harvey, D., Reed, B.R., Jagust, W.J., DeCarli, C., Beckett, L., Mack, W.J., Kramer, J.H., Weiner, M.W., Schuff, N., & Chui, H.C. (2005). Longitudinal volumetric MRI change and rate of cognitive decline. Neurology, 65, 565571.

Mungas, D., Jagust, W.J., Reed, B.R., Kramer, J.H., Weiner, M.W., Schuff, N., Norman, D., Mack, W.J., Willis, L., & Chui, H.C. (2001). MRI predictors of cognition in subcortical ischemic vascular disease and Alzheimer's disease. Neurology, 57, 22292235.

Mungas, D., Reed, B.R., & Kramer, J.H. (2003). Psychometrically matched measures of global cognition, memory, and executive function for assessment of cognitive decline in older persons. Neuropsychology, 17, 380392.

Reed, B.R., Eberling, J.L., Mungas, D., Weiner, M., & Jagust, W.J. (2001). Frontal lobe hypometabolism predicts cognitive decline in patients with lacunar infarcts. Archives of Neurology, 58, 493497.

Reed, B.R., Eberling, J.L., Mungas, D., Weiner, M., Kramer, J.H., & Jagust, W.J. (2004). Effects of white matter lesions and lacunes on cortical function. Archives of Neurology, 61, 15451550.

Reed, B.R., Eberling, J.L., Mungas, D., Weiner, M.W., & Jagust, W.J. (2000). Memory failure has different mechanisms in subcortical stroke and Alzheimer's disease. Annals of Neurology, 48, 275284.

Richardson, E.D., Nadler, J.D., & Malloy, P.F. (1995). Neuropsychologic prediction of performance measures of daily living skills in geriatric patients. Neuropsychology, 9, 565572.

Ritchie, K., Artero, S., & Touchon, J. (2001). Classification criteria for mild cognitive impairment: A population-based validation study. Neurology, 56, 3742.

Royall, D.R. (2006). Mild cognitive impairment and functional status. Journal of the American Geriatric Society, 54, 163165.

Royall, D.R., Palmer, R., Chiodo, L.K., & Polk, M.J. (2004). Declining executive control in normal aging predicts change in functional status: The Freedom House Study. Journal of the American Geriatric Society, 52, 346352.

Royall, D.R., Palmer, R., Chiodo, L.K., & Polk, M.J. (2005). Executive control mediates memory's association with change in instrumental activities of daily living: The Freedom House Study. Journal of the American Geriatric Society, 53, 1117.

Schmeidler, J., Mohs, R.C., & Aryan, M. (1998). Relationship of disease severity to decline on specific cognitive and functional measures in Alzheimer disease. Alzheimers Disease and Associated Disorders, 12, 146151.

Skurla, E., Rogers, J.C., & Sunderland, T. (1988). Direct assessment of activities of daily living in Alzheimer's disease. A controlled study. Journal of the American Geriatric Society, 36, 97103.

Stern, Y., Hesdorffer, D., Sano, M., & Mayeux, R. (1990). Measurement and prediction of functional capacity in Alzheimer's disease. Neurology, 40, 814.

Visser, P.J., Scheltens, P., Verhey, F.R., Schmand, B., Launer, L.J., Jolles, J., & Jonker, C. (1999). Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment. Journal of Neurology, 246, 477485.

Welsh, K.A., Butters, N., Hughes, J.P., Mohs, R.C., & Heyman, A. (1992). Detection and staging of dementia in Alzheimer's disease. Use of the neuropsychological measures developed for the Consortium to Establish a Registry for Alzheimer's Disease. Archives of Neurology, 49, 448452.

White, L., Small, B.J., Petrovitch, H., Ross, G.W., Masaki, K., Abbott, R.D., Hardman, J., Davis, D., Nelson, J., & Markesbery, W. (2005). Recent clinical-pathologic research on the causes of dementia in late life: Update from the Honolulu-Asia Aging Study. Journal of Geriatric Psychiatry and Neurology, 18, 224227.

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Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
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