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