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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.