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Abstract
Background
Impairment in activities of daily living (ADL) is a major problem in Alzheimer's disease (AD), and is related to increased caregiver burden.The present study evaluated whether there are any components of initial dementia evaluation that could predict ADL decline in years follow-up.
Methods
The 32 subjects underwent more than two consecutive neuropsychological evaluation and maintained anti-dementia medication from the Ewha Dementia Cohort. The first clinical, neuropsychological test results, medial temporal atrophy rating and white matter ratings were correlated with the final ADL scores. The subjects were further divided into ADL-preserved and declined groups for the comparison depending on final ADL scores.
Results
The annual decline of the Korean Mini-mental status examination (K-MMSE) score was 1.5±1.2 and of the Seoul-instrumental ADL score was 6.1±4.6. The Factors correlated with the ADL at baseline were the clinical dementia rating, K-MMSE, memory function score and the total neuropsychological test score, left medial temporal lobe atrophy rating, and the neuropsychiatric total score. Only the neuropsychological component including total test, frontal and visuospatial function scores were statistically different between the two groups in the baseline evaluation.
Figures and Tables
Table 2
Correlation coefficients between baseline evaluationfactors andS-IADL atbaseline and follow-up
*p<0.05; **p<0.01. Data were adjusted by age, education.
S-IADL, Seoul instrumental activities of daily living; K-MMSE, Korean minimal mental status examination; SNSB-D, Seoul neuropsychological screening battery-dementia version; SNSB-L, Seoul neuropsychological screening battery-memory; SNSB-L, Seoul neuropsychological screening battery-language; SNSB-D, Seoul neuropsychological screening battery-frontal; CDR, clinical dementia rating; CDR-SB, clinical dementia rating-sum of box; NPI, neuropsychiatric inventory; L-MTA, left medial temporal atrophy; B-MTA, both medial temporal atrophy; NS, non-significant; NP, not performed.
Table 3
Correlation coefficients between baseline evaluation factors and medial temporal lobe atrophyat baseline imaging
*p<0.05; **p<0.01. Data were adjusted by age, education, and ischemic change.
S-IADL, Seoul instrumental activities of daily living; K-MMSE, Korean minimal mental status examination; SNSB-D, Seoul neuropsychological screening battery-dementia version; SNSB-M, Seoul neuropsychological screening battery-memory; CDR, clinical dementia rating; CDR-SB, clinical dementia rating -sum of box; MTA, medial temporal atrophy.
Table 4
The comparison between ADL-preserved groupandADL-aggravated group
S-IADL, Seoul instrumental activities of daily living; K-MMSE, Korean minimal mental status examination; SNSB, Seoul neuropsychological screening battery; CDR, clinical dementia rating; CDR-SB, clinical dementia rating-sum of box; GDS, geriatric depression scale; NPI, neuropsychiatric inventory; MTA, medial temporal atrophy.
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