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Curr Alzheimer Res. 2014;11(8):785-91.

SIST-M-IR activities of daily living items that best discriminate clinically normal elderly from those with mild cognitive impairment.

Author information

1
Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, 221 Longwood Avenue, BL-104H, Boston, MA 02115, USA. gamarshall@partners.org.

Abstract

BACKGROUND:

Activities of daily living (ADL) impairment is a hallmark of Alzheimer's disease (AD) dementia, but impairment in instrumental ADL (IADL) has been reported in mild cognitive impairment (MCI). The Structured Interview and Scoring Tool-Massachusetts Alzheimer's Disease Research Center (MADRC)-Informant Report (SIST-MIR) includes 60 graded items that assist in scoring the Clinical Dementia Rating; it assesses the spectrum of cognitive and ADL changes relevant to early AD. Of the 60 SIST-M-IR items, 41 address IADL; we aimed to determine which of these best discriminate individuals with MCI from clinically normal (CN) elderly.

METHODS:

We assessed 447 subjects participating in the MADRC longitudinal cohort (289 CN, 158 MCI). We performed logistic regression analyses predicting the probability of CN vs. MCI diagnosis using the SIST-M-IR items. Analyses were adjusted for demographic characteristics.

RESULTS:

We found that 4 SIST-M-IR items best discriminated between CN and MCI subjects (MCI performing worse than CN): "participating in games that involve retrieving words" (p=0.0001), "navigating to unfamiliar areas" (p=0.001), "performing mental tasks involved in a former primary job" (p=0.002), and "fixing things or finishing projects" (p=0.002).

CONCLUSIONS:

Our results point to the earliest functional changes seen in elderly at risk for AD, which could be captured by a few simple questions. Honing the sensitivity of clinical assessment tools will help clinicians differentiate those individuals with normal aging from those who are developing cognitive impairment.

PMID:
25212917
PMCID:
PMC4163929
[Indexed for MEDLINE]
Free PMC Article

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