“HOW CAN I HELP YOU?” IDENTIFYING SPECIFIC FUNCTIONAL NEEDS IN MILD COGNITIVE IMPAIRMENT

Abstract

Diagnostic criteria for mild cognitive impairment (MCI) excludes functional deficits. Yet, recent studies demonstrate that older adults with MCI can exhibit impairment in instrumental activities of daily living (IADL). Simultaneous identification of MCI and specific IADLs that require caregiver assistance (e.g., cooking versus finances) can aid healthcare providers in mitigating safety concerns that often precipitate loss of independence. The study objectives were: (1) estimate the odds of requiring assistance on specific IADLs associated with MCI, and (2) test the utility of a cognitive test for predicting the severity of IADL impairment. Participants (N = 226) were older adult (M age = 77.67 ± 10.41) community dwellers and sub-acute rehabilitation patients in Maryland, USA, with MCI (68.14%) or no cognitive impairment (31.86%). The Brief Cognitive Assessment Tool (BCAT) measured cognition and the Functional Activities Questionnaire (FAQ) assessed IADL impairment. Participants with MCI required assistance on significantly more IADLs (M = 3.83, SD = 3.03) than those without cognitive impairment (M = 1.06, SD = 2.10); p < 0.001, Cohen’s d = 1.14. IADL impairment can occur even in MCI, particularly with shopping (odds ratio [OR] = 2.07), remembering appointments/medication (OR = 2.07), and managing bills (OR = 2.02). In a hierarchical regression, cognitive functioning (β = 0.45) explained 20% of the variance in the severity of IADL impairment beyond demographic variables (p < 0.001). Cognitive testing suggestive of MCI should alert clinicians to investigate older adult’s specific functional limitations to identify targets for caregiver support and lower risk of adverse consequences.