Abstract Details

Title Longitudinal Declines in Instrumental Activities of Daily Living in Stable and Progressive Mild Cognitive Impairment

Topic Behavioral Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 154

Objective

Background BACKGROUND: A key distinction between MCI and dementia is the presence of "essentially intact" IADLs in MCI. However, previous studies revealed subtle IADL deficits in MCI that were associated with subsequent progression to dementia. IADL deficits increase from MCI to dementia, but their longitudinal course and magnitude remain uncertain.

Design/Methods DESIGN/METHODS: We identified 2451 participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set who met criteria for MCI at baseline and had at least one annual follow-up visit. IADLs were longitudinally assessed with the Functional Activities Questionnaire (FAQ). Participants were divided into stable (sMCI; n=1331) or progressive (pMCI; n=1120) MCI groups based on progression to dementia during follow-up. Longitudinal FAQ changes were compared between groups. Data from pMCI visits subsequent to initial dementia diagnosis were censored.

Results RESULTS: Across each subject's last two visits, the pMCI group exhibited greater mean changes in both total FAQ (6.13, SD=6.94) and average FAQ item (0.63, SD=0.68) scores than the sMCI group (total FAQ: 0.89, SD=3.53; average FAQ item: 0.10, SD=0.37). Increases in global FAQ indices for the pMCI group were broadly driven by disproportionately worsening performance across 7 of 10 IADL categories. Analyses of earlier time-points indicated that global FAQ indices in the two groups began to diverge by 28 months prior to the final visit.

Conclusions CONCLUSIONS: Our results suggest that progressive deterioration in IADLs can be detected in MCI as early as two years prior to diagnosis of dementia. Progression from MCI to dementia was associated with accelerated declines across multiple categories of IADL performance. Further analyses will focus upon comparisons of the relative magnitude and time course of longitudinal changes in cognitive, functional, and behavioral indices associated with the transition from MCI to dementia.

Authors/Disclosures
Julia J. Hsiao, MD (Optum) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Edmond Teng, MD, PhD (Genentech)	Dr. Teng has received personal compensation for serving as an employee of Genentech. An immediate family member of Dr. Teng has received personal compensation for serving as an employee of Evidation Health. Dr. Teng has stock in F. Hoffman-La Roche. An immediate family member of Dr. Teng has stock in Evidation Health. Dr. Teng has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Teng has received intellectual property interests from a discovery or technology relating to health care.
Rohit Bakshi, MD, FAAN	Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Bakshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. The institution of Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuroimaging. The institution of Dr. Bakshi has received research support from Bristol Myers Squibb. The institution of Dr. Bakshi has received research support from EMD Serono. The institution of Dr. Bakshi has received research support from Novartis.

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