OBJECTIVE: To evaluate whether ratings on Clinical Dementia Rating (CDR) items related to instrumental activities of daily living (IADL) are associated with cognitive or brain morphometric characteristics of participants with mild cognitive impairment (MCI) and global CDR scores of 0.5. METHODS: Baseline cognitive and morphometric data were analyzed for 283 individuals with MCI who were divided into 2 groups (impaired and intact) based on their scores on the 3 CDR categories assessing IADL. Rates of progression to Alzheimer disease (AD) over 2 years were also compared in the 2 groups. RESULTS: The impaired IADL MCI group showed a more widespread pattern of gray matter loss involving frontal and parietal regions, worse episodic memory and executive functions, and a higher percentage of individuals progressing to AD than the relatively intact IADL MCI group. CONCLUSIONS: The results demonstrate the importance of considering functional information captured by the CDR when evaluating individuals with MCI, even though it is not given equal weight in the assignment of the global CDR score. Worse impairment on IADL items was associated with greater involvement of brain regions beyond the mesial temporal lobe. The conventional practice of relying on the global CDR score as currently computed underutilizes valuable IADL information available in the scale, and may delay identification of an important subset of individuals with MCI who are at higher risk of clinical decline.
OBJECTIVE: To evaluate whether ratings on Clinical Dementia Rating (CDR) items related to instrumental activities of daily living (IADL) are associated with cognitive or brain morphometric characteristics of participants with mild cognitive impairment (MCI) and global CDR scores of 0.5. METHODS: Baseline cognitive and morphometric data were analyzed for 283 individuals with MCI who were divided into 2 groups (impaired and intact) based on their scores on the 3 CDR categories assessing IADL. Rates of progression to Alzheimer disease (AD) over 2 years were also compared in the 2 groups. RESULTS: The impaired IADL MCI group showed a more widespread pattern of gray matter loss involving frontal and parietal regions, worse episodic memory and executive functions, and a higher percentage of individuals progressing to AD than the relatively intact IADL MCI group. CONCLUSIONS: The results demonstrate the importance of considering functional information captured by the CDR when evaluating individuals with MCI, even though it is not given equal weight in the assignment of the global CDR score. Worse impairment on IADL items was associated with greater involvement of brain regions beyond the mesial temporal lobe. The conventional practice of relying on the global CDR score as currently computed underutilizes valuable IADL information available in the scale, and may delay identification of an important subset of individuals with MCI who are at higher risk of clinical decline.
Authors: Bruce Fischl; David H Salat; Evelina Busa; Marilyn Albert; Megan Dieterich; Christian Haselgrove; Andre van der Kouwe; Ron Killiany; David Kennedy; Shuna Klaveness; Albert Montillo; Nikos Makris; Bruce Rosen; Anders M Dale Journal: Neuron Date: 2002-01-31 Impact factor: 17.173
Authors: Katherine J Bangen; Amy J Jak; Dawn M Schiehser; Lisa Delano-Wood; Elizabeth Tuminello; S Duke Han; Dean C Delis; Mark W Bondi Journal: J Int Neuropsychol Soc Date: 2010-04-07 Impact factor: 2.892
Authors: Yu-Ling Chang; Mark W Jacobson; Christine Fennema-Notestine; Donald J Hagler; Robin G Jennings; Anders M Dale; Linda K McEvoy Journal: Cereb Cortex Date: 2009-09-23 Impact factor: 5.357
Authors: M H Tabert; S M Albert; L Borukhova-Milov; Y Camacho; G Pelton; X Liu; Y Stern; D P Devanand Journal: Neurology Date: 2002-03-12 Impact factor: 9.910
Authors: R Ryan Darby; Michael Brickhouse; David A Wolk; Bradford C Dickerson Journal: J Neurol Neurosurg Psychiatry Date: 2017-06-19 Impact factor: 10.154
Authors: Emily C Edmonds; Lisa Delano-Wood; Lindsay R Clark; Amy J Jak; Daniel A Nation; Carrie R McDonald; David J Libon; Rhoda Au; Douglas Galasko; David P Salmon; Mark W Bondi Journal: Alzheimers Dement Date: 2014-05-22 Impact factor: 21.566
Authors: David J Libon; Mark W Bondi; Catherine C Price; Melissa Lamar; Joel Eppig; Denene M Wambach; Christine Nieves; Lisa Delano-Wood; Tania Giovannetti; Carol Lippa; Anahid Kabasakalian; Stephanie Cosentino; Rod Swenson; Dana L Penney Journal: J Int Neuropsychol Soc Date: 2011-09 Impact factor: 2.892
Authors: Maria Vassilaki; Jeremiah A Aakre; Walter K Kremers; Michelle M Mielke; Yonas E Geda; Mary M Machulda; David S Knopman; Preciosa M Coloma; Barbara Schauble; Prashanthi Vemuri; Val J Lowe; Clifford R Jack; Ronald C Petersen; Rosebud O Roberts Journal: J Am Geriatr Soc Date: 2018-11-21 Impact factor: 5.562
Authors: Stephen T Moelter; Megan A Glenn; Sharon X Xie; Jesse Chittams; Christopher M Clark; Marianne Watson; Steven E Arnold Journal: Alzheimer Dis Assoc Disord Date: 2015 Apr-Jun Impact factor: 2.703
Authors: Lindsay R Clark; Rebecca L Koscik; Christopher R Nicholas; Ozioma C Okonkwo; Corinne D Engelman; Lisa C Bratzke; Kirk J Hogan; Kimberly D Mueller; Barbara B Bendlin; Cynthia M Carlsson; Sanjay Asthana; Mark A Sager; Bruce P Hermann; Sterling C Johnson Journal: Arch Clin Neuropsychol Date: 2016-11-22 Impact factor: 2.813
Authors: Deborah A Lowe; Steve Balsis; Tyler M Miller; Jared F Benge; Rachelle S Doody Journal: Dement Geriatr Cogn Disord Date: 2012 Impact factor: 2.959