Journal of the International Neuropsychological Society

Research Articles

Profiles of functional deficits in mild cognitive impairment and dementia: benefits from objective measurement

FERNANDA SPEGGIORIN PEREIRAa1, MÔNICA SANCHES YASSUDAa2, ALEXANDRA MARTINI OLIVEIRAa1, BRENO SATLER DINIZa1, MÁRCIA RADANOVICa1, LEDA LEME TALIBa1, WAGNER FARID GATTAZa1 and ORESTES VICENTE FORLENZAa1 c1

a1 Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil

a2 Department of Gerontology, School of Arts, Sciences and Humanities (EACH). University of São Paulo, São Paulo, São Paulo, Brazil

Abstract

The magnitude of functional impairment that may indicate the threshold between MCI and incipient Alzheimer’s disease (AD) has not been clearly defined. The objective was to examine the pattern of functional impairment in the continuum MCI-AD. Eighty-nine older adults (32 cognitively unimpaired, 31 MCI, and 26 AD patients) were examined with the Brazilian version of the Direct Assessment of Functional Status (DAFS-BR) at a university-based memory clinic. MCI patients were sub-divided according to the progression to AD upon follow-up, and had baseline cognitive, functional and biological variables analyzed. MCI patients displayed mild deficits in functional abilities, with intermediate scores as compared to controls and AD. The DAFS-BR items that differentiated MCI from controls involved the ability to deal with finances and shopping skills. At baseline, scores obtained by MCI patients who converted to AD were not significantly different from scores of nonconverters. The magnitude of functional deficits was associated with AD-like pathological findings in the CSF. In conclusion, MCI patients present with early functional changes in complex, instrumental abilities that require the integrity of memory and executive functions. The objective measurement of the functional state may help identify older adults with increased risk of developing dementia in the MCI-AD continuum. (JINS, 2010, 16, 297–305.)

(Received May 12 2009)

(Reviewed December 12 2009)

(Accepted December 13 2009)

Correspondence:

c1 Correspondence and reprint requests to: Orestes V. Forlenza, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovídio Pires de Campos 785, 3rd floor, 05403-010 São Paulo, S.P., Brazil. E-mail: forlenza@usp.br