Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review

Springer Science and Business Media LLC - Tập 7 - Trang 1-20 - 2015
Katrin Jekel1,2, Marinella Damian2, Carina Wattmo3, Lucrezia Hausner2, Roger Bullock4, Peter J Connelly5, Bruno Dubois6, Maria Eriksdotter7, Michael Ewers8, Elmar Graessel9, Milica G Kramberger10, Emma Law11, Patrizia Mecocci12, José L Molinuevo13, Louise Nygård14, Marcel GM Olde-Rikkert15, Jean-Marc Orgogozo16, Florence Pasquier17, Karine Peres18,19, Eric Salmon20, Sietske AM Sikkes21, Tomasz Sobow22, René Spiegel23, Magda Tsolaki24, Bengt Winblad25, Lutz Frölich2
1Network Aging Research, Heidelberg University, Heidelberg, Germany
2Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
3Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
4Kingshill Research Centre, Victoria Hospital, Swindon, UK
5Hon Senior Lecturer in Psychiatry at the University of Dundee, Murray Royal Hospital, Perth, UK
6Centre des Maladies Cognitives et Comportementales (IM2A), Institut du Cerveau et de la Moelle épinière (ICM), UMR-S975, Université Pierre et Marie Curie- Paris6, AP-HP, Hôpital de la Salpêtrière, Paris, France
7Department of Neurobiology Care Sciences and Society (NVS) Karolinska Institutet, Huddinge, Sweden
8Institute of Health and Nursing Science, Charité Center 1 for Health and Human Sciences, Berlin, Germany
9Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
10Department of Neurology, Centre for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
11Scottish Dementia Clinical Research Network, Murray Royal Hospital, Perth, UK
12Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
13Alzheimer’s Disease and Other Cognitive Disorders Unit, ICN, Hospital Clínic i Universitari, IDIBAPS, Barcelona, Spain
14Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
15Department of Geriatrics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
16Department of Clinical Neurosciences, University Hospital Pellegrin, Bordeaux, France
17INSERM U1171, CHU, Memory Clinic, University of Lille, rue Emile Laine, Lille, France
18University of Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
19INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
20Memory Clinic, Department of Neurology, University of Liège, Liège, Belgium
21Alzheimer Center and Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
22Department of Medical Psychology, Medical University of Lodz, Lodz, Poland
23Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland
243rd Department of Neurology, Aristotle University, Thessaloniki, Greece
25Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden

Tóm tắt

There is a growing body of evidence that subtle deficits in instrumental activities of daily living (IADL) may be present in mild cognitive impairment (MCI). However, it is not clear if there are IADL domains that are consistently affected across patients with MCI. In this systematic review, therefore, we aimed to summarize research results regarding the performance of MCI patients in specific IADL (sub)domains compared with persons who are cognitively normal and/or patients with dementia. The databases PsycINFO, PubMed and Web of Science were searched for relevant literature in December 2013. Publications from 1999 onward were considered for inclusion. Altogether, 497 articles were retrieved. Reference lists of selected articles were searched for potentially relevant articles. After screening the abstracts of these 497 articles, 37 articles were included in this review. In 35 studies, IADL deficits (such as problems with medication intake, telephone use, keeping appointments, finding things at home and using everyday technology) were documented in patients with MCI. Financial capacity in patients with MCI was affected in the majority of studies. Effect sizes for group differences between patients with MCI and healthy controls were predominantly moderate to large. Performance-based instruments showed slight advantages (in terms of effect sizes) in detecting group differences in IADL functioning between patients with MCI, patients with Alzheimer’s disease and healthy controls. IADL requiring higher neuropsychological functioning seem to be most severely affected in patients with MCI. A reliable identification of such deficits is necessary, as patients with MCI with IADL deficits seem to have a higher risk of converting to dementia than patients with MCI without IADL deficits. The use of assessment tools specifically designed and validated for patients with MCI is therefore strongly recommended. Furthermore, the development of performance-based assessment instruments should be intensified, as they allow a valid and reliable assessment of subtle IADL deficits in MCI, even if a proxy is not available. Another important point to consider when designing new scales is the inclusion of technology-associated IADL. Novel instruments for clinical practice should be time-efficient and easy to administer.

Tài liệu tham khảo

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