Artikel
Prediction of Incident Dementia: Impact of Impairment in Instrumental Activities of Daily Living and Mild Cognitive Impairment – Results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe)
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Veröffentlicht: | 20. September 2011 |
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Gliederung
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Background: There is an increasing call for a stronger consideration of impairment in instrumental activities of daily living (IADL) in the diagnostic criteria of Mild Cognitive Impairment (MCI) in order to improve the prediction of dementia. Thus, the aim of the study was to determine the impact of MCI and IADL impairment on incident dementia.
Methods: Data were derived from the German Study on Ageing, Cognition and Dementia in Primary Care Patients, a longitudinal study of GP patients aged 75 years and older. The impact of MCI and IADL impairment on incident dementia was analysed using Receiver Operating Characteristics, Kaplan-Meier survival analyses and Cox proportional hazards models.
Results: MCI and IADL impairment were found to be significantly associated with higher conversion to, shorter time to, and better predictive power for future dementia. Regarding IADL, a significant impact particularly was found for impairment in responsibility for one’s own medication, shopping, housekeeping, and in the ability to use public transport.
Conclusions: Combining MCI with IADL impairment significantly improves the prediction of future dementia. Even though information on a set of risk factors is required to achieve a predictive accuracy for dementia in subjects with MCI being clinically useful, IADL impairment should be a very important element of such a risk factor set.
Declaration of Interest: This publication is part of the German Research Network on Dementia (KND) and the German Research Network on Degenerative Dementia (KNDD) and was funded by the German Federal Ministry of Education and Research.