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Table 2 Studies investigating global instrumental activities of daily living functioning a

From: Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review

Author

Year

MCI criteria

Number of subjects

Mean age, yr (SD)

Mean MMSE score (SD)

IADL measures used

Results and effect sizes (Cohen’s d )

Performance-based instruments

Binegar et al. [57]

2009

Petersen

30 MCI

MCI 72.8 (7.9)

MCI 27.3 (2.2)

TFLS

Total score: MCI < NC (d = 0.61); subscales: significant for memory subscale (d = 0.85), but not for time/orientation, money, communication, dressing

Clinical

30 NC

NC 73.7 (6.9)

NC 29.2 (1.0)

ns

significant

Giovannetti et al. [24]

2008

Petersen

25 MCI

MCI 72.2 (6.7)

MCI 27.6 (1.4)

NAT

Total score: NC > MCI > AD; MCI versus NC: d = 1.05, MCI versus AD: d = 1.46

Error score: NC < MCI < AD; MCI versus NC: d = 0.74, MCI versus AD: d = 1.78

1.5 SD below

18 NC

NC 73.1 (3.2)

NC 28.5 (1.0)

 

MMSE ≥25

25 mild AD

AD 73.6 (3.8)

AD 22.4 (2.8)

ns

(NC = MCI) > AD, P < 0.05

Goldberg et al. [25]

2010

Petersen

26 MCI

MCI 77.5 (7.1)

MCI 26.1 (2.3)

UCSD-UPSA

UCSD-UPSA: NC > MCI > AD; MCI versus NC: d = 0.86, MCI versus AD: d = 1.81

ADCS-ADL: (NC = MCI ) > AD; MCI versus AD: d = 1.81

1.5 SD below

50 NC

NC 68.8 (9.9)

NC 28.5 (1.5)

Additional informant-report: ADCS-ADL (NC: self-report)

CDR 0.5

22 AD

AD 78.4 (5.4)

AD 20.3 (3.4)

MMSE ≥24

Pereira [60]

2010

Petersen

31 MCI

MCI 72.6 (7.0)

MCI 27.3 (2.3)

DAFS

DAFS total score NC > MCI > AD; MCI versus NC: d = 1.58, MCI versus AD: d = 2.18

DAFS subdomains: NC > MCI for finances and shopping, but not time orientation, communication, grooming, eating, which were worse only in AD;

IQCODE total score: NC > MCI > AD; MCI versus NC: d = 1.00, MCI versus AD: d = 0.77

Clinical

32 NC

NC 71.6 (5.6)

NC 28.8 (1.5)

26 AD

AD 77.9 (6.0)

AD 19.5 (5.5)

Additional informant-report: IQCODE

AD > (MCI/NC)

AD < (MCI = NC)

Schmitter-Edgecombe et al. [34]

2012

Petersen

38 MCI

MCI 70.5 (8.6)

Not reported

DOT

DOT: MCI < NC for completion time (d = 0.60) and accuracy (d = 0.61)

1.5 SD below

38 NC

NC 69.3 (7.9)

Additional informant-report: KI-ADL

KI-ADL: MCI < NC (d = 0.50)

ns

 

Wadley et al. [50]

2008

Petersen

50 MCI

MCI 70.0 (7.9)

Not reported

Timed IADL

MCI = NC for accuracy

Clinical

59 NC

NC 67.8 (7.1)

MCI < NC for speed (d = 0.75), significant subdomains telephone (d = 0.56), grocery (d = 0.75), medication (d = 0.51), nutrition information (d = 0.52)

ns

Informant-report rating instruments

Ahn et al. [41].

2009

Petersen/Winblad

66 MCI

MCI 70.8 (7.3)

MCI 24.8 (3.1)

Seoul-IADL

MCI < NC (d = 1.62)

1.5 SD below

61 NC

NC 64.4 (5.6)

NC 27.6 (1.4)

CDR 0.5

significant

Boeve et al. [42]

2003

Petersen

13 MCI

MCI 94.3 (2.6)

MCI 26.8 (1.6)

ROIL

MCI = NC, MCI > dementia (d = 2.93)

Clinical

56 NC

NC 93.8 (2.5)

NC 27.9 (2.3)

42 Dementia

Dementia 94.8 (2.6)

Dementia 18.6 (5.0)

ns

AD < (MCI = NC)

Brown et al. [15]

2011

Petersen

394 MCI

MCI 74.9 (7.4)

MCI 27.0 (1.8)

FAQ (NC: self-report)

Severity of deficits: NC > MCI > AD; MCI versus NC: d = 1.04, MCI versus AD: d = 1.71

Number of deficits: NC < MCI < AD; MCI versus NC: d = 1.28, MCI versus AD: d = 1.62

1.5 SD below

229 NC

NC 75.9 (5.0)

NC 29.1 (1.0)

CDR 0.5

193 AD

AD 75.3 (7.5)

AD 23.3 (2.1)

MMSE ≥24

ns

significant

Jefferson et al. [43]

2008

Petersen/Winblad

38 MCI

MCI 74.6 (7.5)

MCI 28.0 (1.7)

L&B IADL

L&B IADL: MCI = NC, FC-ADL: MCI < NC (d = 0.84)

Clinical

39 NC

NCI 72.4 (5.5)

NC 29.3 (0.9)

FC-ADL

ns

significant

Mariani et al. [44]

2008

Petersen/Winblad

132 MCI

MCI 76.1 (5.8)

MCI 25.7 (1.6)

L&B IADL

(MCI: informant-report, NC: self-report)

MCI < NC (d = 0.29)

below normality cutoff

249 NC

NC 72.2 (7.5)

NC 28.1 (1.2)

significant

significant

Pedrosa et al. [45]

2010

Petersen/Winblad

30 MCI

MCI 75.7 (6.4)

MCI 24.4 (3.3)

ADCS-MCI-ADL-18 ADCS-MCI-ADL-24 L&B-IADL

ADCS-MCI-ADL-18: NC > MCI > AD; MCI versus NC: d = 1.39, MCI versus AD: d = 2.27

ADCS-MCI-ADL-24: NC > MCI > AD; MCI versus NC: d = 1.67, MCI versus AD: d = 2.33

L&B IADL: NC > MCI > AD; MCI versus NC: d = 2.0, MCI versus AD: d = 2.89

1 SD below

31 NC

NC 72.2 (8.0)

NC 27.7 (3.0)

33 AD

AD 76.1 (7.5)

AD 16.5 (5.2)

Perneczky et al. [47]

2006

Petersen/Winblad

48 MCI

MCI 69.2 (8.3)

MCI 26.5 (2.3)

ADCS-MCI-ADL-18 Bayer-ADL IQCODE

ADCS-MCI-ADL-18: MCI < NC (d = 1.98)

Bayer-ADL: MCI < NC (d = 1.95)

IQCODE: MCI < NC (d = 1.09)

1 SD below

42 NC

NC 66.7 (9.3)

NC 29.3 (0.7)

CDR 0.5

ns

significant

Perneczky et al. [46]

2006

Petersen/Winblad

45 MCI

MCI 69.2 (8.3)

MCI 26.9 (1.4)

ADCS-MCI-ADL-18 Bayer-ADL

ADCS-MCI-ADL-18: MCI < NC (d = 1.89)

Bayer-ADL: MCI < NC (d = 2.44)

1 SD below

30 NC

NC 66.7 (9.3)

NC 29.3 (0.7)

CDR 0.5

ns

Reppermund et al. [29]

2011

Petersen

293 MCI

MCI 78.8 (4.7)

MCI 28.0 (1.5)

Bayer-ADL

Bayer-ADL total: MCI < NC (d = 0.32)

1.5 SD below

469 NC

NC 78.3 (4.7)

NC 28.8 (1.2)

Bayer-ADL high cognitive demand: MCI < NC (d = 0.40)

ns

Bayer-ADL low cognitive demand: MCI = NC

Reppermund et al. [28]

2013

Petersen

227 MCI

MCI 78.6 (4.4)

MCI 28.3 (1.4)

Bayer-ADL

Bayer-ADL total: MCI < NC (d = 0.39)

1.5 SD below

375 NC

NC 77.9 (4.6)

NC 28.9 (1.2)

 

Bayer-ADL high cognitive demand: MCI < NC (d = 0.40)

Bayer-ADL low cognitive demand: MCI < NC (d = 0.27), IADL performance at baseline predicted conversion to dementia at 2-year follow-up

ns

significant

Self-report rating instruments

Kim et al. [36]

2009

Winblad

255 MCI

MCI 72.0 (6.0)

MCI 23.1 (4.5)

Seoul-IADL

MCI < NC (d = 0.27)

1 SD below

311 NC

NC 70.7 (6.0)

NC 26.5 (3.3)

significant

significant

Peres et al. [27]

2006

Petersen

285 MCI

Total sample: 80.8 (5.6)

Not reported

4-IADL

NC > MCI > dementia

1.5 SD below

828 NC

149 dementia

Comparison of MCI subtypes: informant-report rating instruments

Aretouli et al. [23]

2010

Petersen

124 MCI

MCI 76.3 (7.5)

MCI 28.2 (1.3)

ADL-PI IQCODE

ADL-PI: MCI < NC, P < 0.001; all MCI subgroups < NC, P < 0.001, md = sd; am = nonam

IQCODE: MCI < NC, P < 0.001; true for all subgroups; multiple > single, am = nonam

1.5 SD below

(36 asMCI

NC 72.4 (7.3)

NC 29.3 (0.9)

CDR 0.5

45 amMCI

significant

significant

26 nasMCI

17 namMCI)

68 NC

Luck et al. [58]

2011

Winblad

161 MCI

MCI 81.9 (5.0)

Not reported

9 IADL items (Schneekloth and Potthoff [80])

MCI < NC (aMCI = naMCI; aMCI < NC (d = 0.17), naMCI = NC)

MCI + IADL deficits: higher risk of conversion to dementia

MCI + IADL: 47.4% versus MCI-IADL: 31.4%;

NC + IADL: 26.7% versus NC-IADL: 8.0%

1 SD below

(36 asMCI

(aMCI 81.6 (4.8),

42 amMCI

naMCI 82.2 (5.2))

60 nasMCI

NC 81.2 (4.7)

23 namMCI)

ns

723 NC

 

de Rotrou [40]

2012

Petersen

53 MCI

MCI 78.6 (7.3)

MCI 26.2 (2.2)

DAD-6

NC > MCI > AD; MCI versus NC: d = 1.29, MCI versus AD: d = 1.66

NC > sdMCI (d = 1.59), sdMCI > mdMCI (d = 1.37)

Clinical

(29 sdMCI

NC 80.9 (4.2)

NC 29.1 (1.0)

 

24mdMCI)

Dementia 80.6 (6.2)

Dementia 25.5 (1.8)

55 NC

ns

All significant

31 Dementia

Tam et al. [48]

2007

Petersen/Winblad

54 asMCI

asMCI 79.3 (6.1)

asMCI 25.4 (3.0)

DAD

IADL subscale: (NC = asMCI) > amMCI > AD; amMCI versus NC: d = 0.98, asMCI versus amMCI: d = 0.80, asMCI versus AD: d = 2.93, amMCI versus AD: d = 1.71

CDR 0.5

93 amMCI

amMCI 80.1 (6.5)

amMCI 22.3 (3.1)

1 SD below

78 NC

NC 77.1 (5.1)

NC 27.2 (2.1)

85 AD

AD 84.5 (5.9)

AD 17.9 (3.2)

Teng et al. [31]

2010

Petersen

1108 MCI

as 77.0 (9.2)

as 27.8 (1.8)

FAQ

NC > asMCI/amMCI/nasMCI; asMCI = amMCI, nasMCI = namMCI

MMSE ≥24

(532 asMCI

am 75.3 (8.5)

am 27.4 (1.8)

340 amMCI

nas 74.1 (8.6)

nas 28.2 (1.7)

162 nasMCI

nam 73.0 (6.8)

nam 27.8 (1.5)

74 namMCI)

NC 74.8 (9.1)

NC 29.0 (1.2)

   

3,036 NC

significant

   

Yeh et al. [33]

2011

Petersen

56 asMCI

asMCI 77.5 (6.7)

asMCI 26.6 (1.6)

DAD

NC > MCI (as = am) > AD; asMCI versus NC: d = 0.9, amMCI versus NC: d = 1.06, asMCI versus AD: d = 2.23, amMCI versus AD: d = 1.9

1 SD below

94 amMCI

amMCI 78.9 (5.8)

amMCI 25.8 (1.6)

MMSE ≥24

64 NC

NC 76.5 (6.6)

NC 28.5 (1.3)

102 AD

AD 79.6 (6.1)

AD 20.9 (3.1)

Comparison of MCI subtypes: self-report rating instruments

Wadley et al. [61]

2007

Petersen/Winblad

84 aMCI

aMCI 77.0 (7.0)

aMCI 26.0 (1.9)

IADL (Home Care questionnaire)

IADL performance: aMCI/mdMCI < NC, naMCI = NC; aMCI versus NC: d = 0.23, mdMCI versus NC: d = 0.31; aMCI < naMCI: d = 0.23

IADL difficulty: all MCI subgroups < NC; aMCI versus NC: d = 0.57, naMCI versus NC: d = 0.27, mdMCI versus NC: d = 0.57; aMCI < naMCI: d = 0.23

1.5 SD below

171 naMCI

naMCI 76.5 (6.2)

naMCI 26.2 (2.1)

89 mdMCI

mdMCI 78.8 (6.6)

mdMCI 25.1 (1.8)

2,110 NC

NC 72.9 (5.4)

NC 27.6 (1.8)

significant

Comparison of MCI subtypes and all three types of instruments

Burton et al. [37]

2009

Petersen/Winblad

6 asMCI

asMCI 79.5 (5.7)

asMCI 26.8 (2.5)

Performance-based: EPT

Self-report: SIB-R: NC > mdMCI (d = 0.71), sdMCI > mdMCI (d = 0.45), L&B: MCI = NC; L&B IADL: MCI = NC

Informant-report SIB-R: NC > sdMCI (d = 0.46), NC > mdMCI (d = 0.51); L&B IADL: MCI = NC

EPT: NC > sdMCI > mdMCI; sdMCI versus NC: d = 0.50, sdMCI versus mdMCI: d = 1.54

1 SD below

39 nasMCI

nasMCI 77.5 (5.6)

nasMCI 28.7 (1.3)

Self-report: L&B IADL, SIB-R;

Informant-report: L&B IADL, SIB-R

19 amMCI

amMCI 82.0 (5.0)

amMCI 28.2 (1.3)

28 namMCI

namMCI 79.6 (4.9)

namMCI 28.7 (1.1)

158 NC

NC 73.6 (4.7)

NC 28.9 (1.2)

  1. aAD, Alzheimer’s disease; ADCS-ADL, Alzheimer’s Disease Cooperative Study/Activities of Daily Living Inventory; ADCS-MCI-ADL-18, 18-item Alzheimer’s Disease Cooperative Study/Activities of Daily Living Inventory adapted for patients with mild cognitive impairment; ADCS-MCI-ADL-24, 24-item Alzheimer’s Disease Cooperative Study/Activities of Daily Living Inventory adapted for patients with mild cognitive impairment; ADL, Activities of daily living; ADL-PI, Activities of Daily Living-Prevention Instrument; am, Amnestic multiple domain; aMCI, Amnestic mild cognitive impairment; as, Amnestic single domain; BADL, Basic activities of daily living; Bayer-ADL, Bayer Activities of Daily Living Scale; CDR, Clinical dementia rating; DAD, Disability Assessment for Dementia; DAD-6, 6-item Disability Assessment for Dementia; DAFS, Direct Assessment of Functional Status; DHQ, Driving Habits Questionnaire; DOT, Day-Out Task; EPT, Everyday Problems Test; ETUQ, Everyday Technology Use Questionnaire; FAQ, Functional Activities Questionnaire; FC-ADL, Functional Capacities for Activities of Daily Living; FCI, Financial Capacity Instrument; FC-IADL, Functional Capacities for Instrumental Activities of Daily Living; IADL, Instrumental activities of daily living; 4-IADL, 4-item Instrumental Activities of Daily Living scale items chosen from Lawton and Brody; 9-IADL, 9-item Instrumental Activities of Daily Living scale; ICC, Intraclass correlation coefficient; IQCODE, Informant Questionnaire on Cognitive Decline in the Elderly; KI-IADL, Knowledgeable Informant report about Instrumental Activities of Daily Living; L&B IADL, Lawton and Brody’s Instrumental Activities of Daily Living; MCI, Mild cognitive impairment; md, Multiple domain; META, Management of Everyday Technology Assessment; MMSE, Mini Mental State Examination; nam, Nonamnestic multiple domain; naMCI, Nonamnestic mild cognitive impairment; nas, Nonamnestic single domain; NAT, Naturalistic action task; NC, Normal control; NIA-AA, National Institute on Aging and Alzheimer’s Association; ns, nonsignificant; ROIL, Record of Independent Living; sd, Single domain; SD, Standard deviation; S-IADL, Seoul-Instrumental Activities of Daily Living; SIB-R, Scales of Independent Behavior–Revised; SR-IADL, Self-report Instrumental Activities of Daily Living; TADL-Q, Technology–Activities of Daily Living Questionnaire; TFLS, Texas Functional Living Scale; TIADL, Timed Instrumental Activities of Daily Living; UAB-DA, University of Alabama at Birmingham Driving Assessment; UCSD-UPSA, University of California, San Diego Performance-Based Skills Assessment; VAPS, Virtual Action Planning Supermarket.