Literature DB >> 22188074

Do instrumental activities of daily living predict dementia at 1- and 2-year follow-up? Findings from the Development of Screening guidelines and diagnostic Criteria for Predementia Alzheimer's disease study.

Sietske A M Sikkes1, Pieter Jelle Visser, Dirk L Knol, Elly S M de Lange-de Klerk, Magda Tsolaki, Giovani B Frisoni, Flavio Nobili, Luiza Spiru, Anne Sophie Rigaud, Lutz Frölich, Marcel Olde Rikkert, Hilkka Soininen, Jacques Touchon, Gordon Wilcock, Mercè Boada, Harald Hampel, Roger Bullock, Bruno Vellas, Yolande A L Pijnenburg, Philip Scheltens, Frans R Verhey, Bernard M J Uitdehaag.   

Abstract

OBJECTIVES: To investigate whether problems in instrumental activities of daily living (IADL) can add to conventionally used clinical measurements in helping to predict a diagnosis of dementia at 1- and 2-year follow-up.
DESIGN: Multicenter prospective cohort study.
SETTING: Memory clinics in Europe. PARTICIPANTS: Individuals aged 55 and older without dementia. MEASUREMENTS: IADLs were measured using pooled activities from five informant-based questionnaires. Structural equation modeling (SEM) was used to investigate the relation between IADLs and dementia. Age, sex, education, depression, and cognitive measures (Mini-Mental State Examination and verbal memory) were included in the model.
RESULTS: Five hundred thirty-one participants had baseline and 1-year follow-up assessments; 69 (13.0%) of these had developed dementia at 1-year follow-up. At 2-year follow-up, 481 participants were seen, of whom 100 (20.8%) had developed dementia. Participants with IADL disabilities at baseline had a higher conversion rate (24.4%) than participants without IADL disabilities (16.7%) (chi-square = 4.28, degrees of freedom = 1, P = .04). SEM showed that IADL disability could help predict dementia in addition to the measured variables at 1-year follow-up (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.51-3.13) and 2-year follow-up (OR = 2.11, 95% CI = 1.33-3.33).
CONCLUSION: IADL disability is a useful addition to the diagnostic process in a memory clinic setting, indicating who is at higher risk of developing dementia at 1- and 2-year follow-up.
© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

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Year:  2011        PMID: 22188074     DOI: 10.1111/j.1532-5415.2011.03732.x

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


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