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Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population

Published online by Cambridge University Press:  22 April 2015

P. De Vriendt ,
T. Mets ,
M. Petrovic  and
E. Gorus
P. De Vriendt*
Affiliation:
Frailty in Ageing (FRIA) Research Group and Department of Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium Research in Gerontology and Geriatrics (REGG), Alliance Research group between FRIA, Gerontology and Geriatrics departments from the Vrije Universiteit Brussel and Universitair Ziekenhuis Brussel, Brussels, Belgium, and Department of Geriatrics from the Ghent University and Ghent University Hospital, Ghent, Belgium
T. Mets
Affiliation:
Frailty in Ageing (FRIA) Research Group and Department of Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium Research in Gerontology and Geriatrics (REGG), Alliance Research group between FRIA, Gerontology and Geriatrics departments from the Vrije Universiteit Brussel and Universitair Ziekenhuis Brussel, Brussels, Belgium, and Department of Geriatrics from the Ghent University and Ghent University Hospital, Ghent, Belgium Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
M. Petrovic
Affiliation:
Research in Gerontology and Geriatrics (REGG), Alliance Research group between FRIA, Gerontology and Geriatrics departments from the Vrije Universiteit Brussel and Universitair Ziekenhuis Brussel, Brussels, Belgium, and Department of Geriatrics from the Ghent University and Ghent University Hospital, Ghent, Belgium Department of Geriatrics, Ghent University Hospital, Ghent, Belgium Department of Geriatrics, Internal Medicine, Ghent University, Belgium
E. Gorus
Affiliation:
Frailty in Ageing (FRIA) Research Group and Department of Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium Research in Gerontology and Geriatrics (REGG), Alliance Research group between FRIA, Gerontology and Geriatrics departments from the Vrije Universiteit Brussel and Universitair Ziekenhuis Brussel, Brussels, Belgium, and Department of Geriatrics from the Ghent University and Ghent University Hospital, Ghent, Belgium Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
*
Correspondence should be addressed to: Patricia De Vriendt, Department of Frailty in Ageing (FRIA) Research Group and Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan, 103, B-1090 Brussels, Belgium. Phone: +32 479 654110; Fax: +32 447 63 64. Email: patricia.de.vriendt@vub.ac.be.
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Abstract

Background:

Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments in the absence of manifest functional decline. Mild changes in activities of daily living (ADL) can be present and probably predict conversion to dementia. A new advanced (a)-ADL tool was developed, evaluating high-level activities and, taking each participant as their own reference, distinguishing a global Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), based on the number of activities performed and the severity and causes of the functional problem. This study evaluates the discriminative validity of the a-ADL in MCI.

Method:

Based upon clinical evaluation and a set of global, cognitive, mood, and functional assessments, 150 community-dwelling participants (average age 80.3 years (SD 5; 66–91)) were included and diagnosed as (1) cognitively healthy participants (n = 50); (2) patients with a-MCI (n = 48), or (3) mild to moderate AD (n = 52). The a-ADL tool was not a part of the clinical evaluation.

Results:

The a-ADL-DI and the a-ADL-CDI showed a sensitivity and specificity ranging from 70% to 94.2%, Positive Predictive Value ranging from 70% till 93.8%, and Negative Predictive Value from 64.4% and 93.8%, an area under the curve (AUC) ranging from 0.791 to 0.960. Functional decline related to physical deficits, as assessed by the a-ADL-PDI, did not discriminate between the different groups.

Conclusion:

The a-ADL tool has a good ability to distinguish normal and pathological cognitive aging. Its discriminative power for underlying causes of limitations may be an advantage.

Keywords

international classification of functioningdisability and healthcognitive disordersAlzheimer’s diseaseassessment of daily functioningADLgeriatric assessmentsensitivityspecificity
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 9 , September 2015 , pp. 1419 - 1427
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Bossuyt, P. M. et al. (2003). Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ, 326, 41–44.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.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. The Journal of Nutrition, Health and Aging, 17, 64–71.Google Scholar
De Vriendt, P., Gorus, E., Cornelis, E., Velghe, A., Petrovic, M. and Mets, T. (2012). The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment. International Psychogeriatrics/IPA, 24, 974–986.Google Scholar
Farias, S. T., Mungas, D. and Jagust, W. (2005). 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, 827–834.Google Scholar
Farias, S. T., Mungas, D., Reed, B. R., Harvey, D., Cahn-Weiner, D. and Decarli, C. (2006). MCI is associated with deficits in everyday functioning. Alzheimer Disease and Associated Disorders, 20, 217–223.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Gallagher, D. et al. (2010). Detecting prodromal Alzheimer's disease in mild cognitive impairment: utility of the CAMCOG and other neuropsychological predictors. International Journal of Geriatric Psychiatry, 25, 1280–1287.CrossRefGoogle ScholarPubMed
Gerstenecker, A. and Mast, B. (2014). Mild cognitive impairment: a history and the state of current diagnostic criteria. International Psychogeriatrics/IPA, 1–13.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, 359–365.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, 375–383.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA, 185, 914–919.Google Scholar
Law, L. L., Barnett, F., Yau, M. K. and Gray, M. A. (2012). Measures of everyday competence in older adults with cognitive impairment: a systematic review. Age and Ageing, 41, 9–16.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.Google Scholar
Malinowsky, C., Almkvist, O., Kottorp, A. and Nygard, L. (2010). Ability to manage everyday technology: a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment. Disability and Rehabilitation Assistive Technology, 5, 462–469.Google Scholar
Mets, T. et al. (2000). Assessment of dementia in elderly outpatients: a comparative study of European centers and consensus statement. Archives of Gerontology and Geriatrics, 30, 17–24.Google Scholar
Nygard, L. (2003). Instrumental activities of daily living: a stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment? Acta Neurologica Scandinavica. Supplementum, 179, 42–46.Google Scholar
Pedrosa, H. et al. (2010). Functional evaluation distinguishes MCI patients from healthy elderly people–the ADCS/MCI/ADL scale. The Journal of Nutrition, Health & Aging, 14, 703–709.CrossRefGoogle ScholarPubMed
Peres, K., Chrysostome, V., Fabrigoule, C., Orgogozo, J. M., Dartigues, J. F. and Barberger-Gateau, P. (2006). Restriction in complex activities of daily living in MCI: impact on outcome. Neurology, 67, 461–466.CrossRefGoogle ScholarPubMed
Peres, K. et al. (2008). Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. Journal of the American Geriatrics Society, 56, 37–44.Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.Google Scholar
Petersen, R. C. (2011). Clinical practice. Mild cognitive impairment. The New England Journal of Medicine, 364, 2227–2234.Google Scholar
Petersen, R. C., Caracciolo, B., Brayne, C., Gauthier, S., Jelic, V. and Fratiglioni, L. (2014). Mild cognitive impairment: a concept in evolution. Journal of Internal Medicine, 275, 214–228.CrossRefGoogle ScholarPubMed
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, 303–308.Google Scholar
Prince, M., Bryce, R. and Ferri, C. (2011). World Alzheimer report. The benefits of early diagnsosis and intervention. London, UK: Alzheimer's Disease International.Google Scholar
Prince, M., Guerchet, M. and Prina, M. (2013). Policy Brief for Heads of Government: the global impact of dementia 2013–2050. In International, A. S. D. (ed.) (p. 8 ). London: Alzheimer's Disease International.Google Scholar
Reuben, D. B. and Solomon, D. H. (1989). Assessment in geriatrics. Of caveats and names. Journal of the American Geriatrics Society, 37, 570–572.Google Scholar
Sikkes, S. A. et al. (2012). A new informant-based questionnaire for instrumental activities of daily living in dementia. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 8, 536–543.Google Scholar
Stephan, B. C., Brayne, C., Savva, G. M. and Matthews, F. E. (2011). Occurrence of medical co-morbidity in mild cognitive impairment: implications for generalisation of MCI research. Age and Ageing, 40, 501–507.Google Scholar
Tabert, M. H. et al. (2002). Functional deficits in patients with mild cognitive impairment: prediction of AD. Neurology, 58, 758–764.Google Scholar
Wadley, V. G. et al. (2009). Mild cognitive impairment and everyday function: an investigation of driving performance. Journal of Geriatric Psychiatry and Neurology, 22, 87–94.Google Scholar
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, 240–246.Google Scholar
Yeh, Y. C., Lin, K. N., Chen, W. T., Lin, C. Y., Chen, T. B. and Wang, P. N. (2011). Functional disability profiles in amnestic mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 31, 225–232.Google Scholar
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.Google Scholar