Supplementary Material for: Increasing the Sensitivity of Functional Status Assessment in the Preclinical Range (Normal to Mild Cognitive Impairment): Exploring the IADL-Extended Approach

2018-07-11T08:17:14Z (GMT) by Fieo R. Stern Y.
<b><i>Background/Aims:</i></b> Dementia exhibits an insidious onset consisting of cognitive, behavioral, and functional impairment. We explored a functional continuum that extends assessment beyond the clinical instrumental activities of daily living (IADL) range and into advanced activities of daily living. <b><i>Methods:</i></b> We examined the predictive power (Cox regression; <i>n</i> = 2,471) of a unidimensional IADL-extended (IADL-x) scale for incident mild cognitive impairment (MCI). We also examined “time to MCI” as an outcome measure. <b><i>Results:</i></b> Each additional task endorsed on the IADL-x hierarchy (e.g., endorsing participation in 6 vs. 5 activities) resulted in a 10% reduction in MCI risk (HR 0.90, 95% CI 0.85–0.94, <i>p</i> < 0.001). For the fully adjusted model the risk reduction dropped to 6%. The odds of incident MCI within 2 years (for those below the median IADL-x total score) was 2.5 times higher (OR 2.60, 95% CI 1.52–4.4, <i>p</i> < 0.001) and 2 times higher for incident MCI within the next 5 years (OR 1.93, 95% CI 1.76–3.2, <i>p</i> < 0.01). <b><i>Conclusion:</i></b> The IADL-x metric appears to be a valid approach for determining the risk of MCI based on one’s position along a formal hierarchy of function.