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The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment

Patricia De Vriendt UGent, Ellen Gorus, Elise Cornelis, Ivan Bautmans, Mirko Petrovic UGent and Tony Mets (2013) JOURNAL OF NUTRITION HEALTH & AGING. 17(1). p.64-71
abstract
Objectives: Assessment of advanced activities of daily living (a-ADL) can be of interest in establishing the diagnosis of Alzheimer's disease (AD) in an earlier stage, since these activities demand high cognitive functioning and are more responsive to subtle changes. In this study we tested a new a-ADL tool, developed according to the International Classification of Functioning, Disability and Health (ICF). The a-ADL tool is based on the total number of activities performed (TNA) by a person and takes each subject as his own reference. It distinguishes a total Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), with lower score representing more independency. We explored whether these indices allow distinction between cognitively healthy persons, patients with Mild Cognitive Impairment (MCI) and patients with mild AD. Methods: Participants were on average 80 years old (SD 4.6; 66-90), were community dwelling, and were diagnosed as (1) cognitively healthy subjects (n=26); (2) patients with MCI (n = 17), or (3) mild AD (n = 25), based upon extensive clinical evaluation and a set of global, cognitive, mood and functional assessments. The a-ADL-tool was not part of the clinical evaluation. Results: The a-ADL-CDI was significantly different between the three groups (p<.01). The a-ADL-DI was significantly different between MCI and AD (p<.001). The tool had good psychometrical properties (inter-rater reliability; agreement between patient and proxy; correlations with cognitive tests). Although the sample size was relatively small, ROC curves were computed for the a-ADL-DI and a-ADL-CDI with satisfactory and promising results. Conclusion: The a-ADL-CDI and a-ADL-DI might offer a useful contribution to the identification and follow up of patients with mild cognitive disorders in an older population.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
cognitive disorders, Alzheimer's disease, disability and health, International classification of functioning, assessment of daily functioning, geriatric assessment, INSTRUMENTAL ACTIVITIES, ALZHEIMERS-DISEASE, COMPLEX ACTIVITIES, DEMENTIA, SCALE, DISABILITY, DIAGNOSIS, CONSENSUS, LANGUAGE, IMPACT
journal title
JOURNAL OF NUTRITION HEALTH & AGING
J. Nutr. Health Aging
volume
17
issue
1
pages
64 - 71
Web of Science type
Article
Web of Science id
000315537200013
JCR category
NUTRITION & DIETETICS
JCR impact factor
2.659 (2013)
JCR rank
31/79 (2013)
JCR quartile
2 (2013)
ISSN
1279-7707
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2061224
handle
http://hdl.handle.net/1854/LU-2061224
date created
2012-03-06 21:56:16
date last changed
2013-07-08 13:39:57
@article{2061224,
  abstract     = {Objectives: Assessment of advanced activities of daily living (a-ADL) can be of interest in establishing the diagnosis of Alzheimer's disease (AD) in an earlier stage, since these activities demand high cognitive functioning and are more responsive to subtle changes. In this study we tested a new a-ADL tool, developed according to the International Classification of Functioning, Disability and Health (ICF). The a-ADL tool is based on the total number of activities performed (TNA) by a person and takes each subject as his own reference. It distinguishes a total Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), with lower score representing more independency. We explored whether these indices allow distinction between cognitively healthy persons, patients with Mild Cognitive Impairment (MCI) and patients with mild AD.
Methods: Participants were on average 80 years old (SD 4.6; 66-90), were community dwelling, and were diagnosed as (1) cognitively healthy subjects (n=26); (2) patients with MCI (n = 17), or (3) mild AD (n = 25), based upon extensive clinical evaluation and a set of global, cognitive, mood and functional assessments. The a-ADL-tool was not part of the clinical evaluation.
Results: The a-ADL-CDI was significantly different between the three groups (p{\textlangle}.01). The a-ADL-DI was significantly different between MCI and AD (p{\textlangle}.001). The tool had good psychometrical properties (inter-rater reliability; agreement between patient and proxy; correlations with cognitive tests). Although the sample size was relatively small, ROC curves were computed for the a-ADL-DI and a-ADL-CDI with satisfactory and promising results.
Conclusion: The a-ADL-CDI and a-ADL-DI might offer a useful contribution to the identification and follow up of patients with mild cognitive disorders in an older population.},
  author       = {De Vriendt, Patricia and Gorus, Ellen and Cornelis, Elise and Bautmans, Ivan  and Petrovic, Mirko and Mets, Tony},
  issn         = {1279-7707},
  journal      = {JOURNAL OF NUTRITION HEALTH \& AGING},
  keyword      = {cognitive disorders,Alzheimer's disease,disability and health,International classification of functioning,assessment of daily functioning,geriatric assessment,INSTRUMENTAL ACTIVITIES,ALZHEIMERS-DISEASE,COMPLEX ACTIVITIES,DEMENTIA,SCALE,DISABILITY,DIAGNOSIS,CONSENSUS,LANGUAGE,IMPACT},
  language     = {eng},
  number       = {1},
  pages        = {64--71},
  title        = {The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment},
  volume       = {17},
  year         = {2013},
}

Chicago
De Vriendt, Patricia, Ellen Gorus, Elise Cornelis, Ivan Bautmans, Mirko Petrovic, and Tony Mets. 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 (1): 64–71.
APA
De Vriendt, P., Gorus, E., Cornelis, E., Bautmans, I., Petrovic, M., & 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(1), 64–71.
Vancouver
1.
De Vriendt P, Gorus E, Cornelis E, Bautmans I, Petrovic M, Mets T. The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment. JOURNAL OF NUTRITION HEALTH & AGING. 2013;17(1):64–71.
MLA
De Vriendt, Patricia, Ellen Gorus, Elise Cornelis, et al. “The Advanced Activities of Daily Living: a Tool Allowing the Evaluation of Subtle Functional Decline in Mild Cognitive Impairment.” JOURNAL OF NUTRITION HEALTH & AGING 17.1 (2013): 64–71. Print.