Patterns of functioning in older adults with mild cognitive impairment: a two-year study focusing on everyday technology use

Objectives: Early detection is vital for persons with mild cognitive impairment (MCI) who are at risk of activity and participation limitations, and crosssectional studies suggest the ability to use everyday technology (ET) to be a sensible tool. However, group level analyses fail to inform us about how functioning can vary over time for individuals. This study aimed at exploring and describing patterns of functioning over two years in a sample newly classified with MCI, with a special focus on perceived difficulty in ET use and involvement in everyday activities. In addition, cognitive functioning and conversion to dementia were studied. Method: 37 older adults (aged ≥ 55) with MCI were assessed at inclusion, and at 6, 12, and 24 months. Longitudinal case plots for the variables under study were analyzed based on strict criteria using a person-oriented approach. Paired t-tests from baseline and 24 months were also conducted to analyze change. Results: The 32 participants who remained in the study after two years showed three distinct patterns of functioning over time: stable/ascending (n = 10), fluctuating (n = 10), and descending (n = 12), with the highest conversion to dementia in the descending pattern (58%). The perceived ability to use ET decreased or fluctuated in 50% of the sample. However, on a group level, a significant difference between baseline and 24 months was found only regarding cognitive function. Conclusion: As the need for support is individual and likely to alter over time, repeated evaluations of activity involvement and difficulty in ET use are suggested to target timely interventions for persons with MCI.

[1]  A. Kazdin Research Design in Clinical Psychology , 2021 .

[2]  Y. Stern Cognitive Reserve: Implications for Assessment and Intervention , 2013, Folia Phoniatrica et Logopaedica.

[3]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[4]  Anders Kottorp,et al.  Detection of activity limitations in older adults with MCI or Alzheimer's disease through evaluation of perceived difficulty in use of everyday technology: A replication study , 2012, Aging & mental health.

[5]  Ellen Gorus,et al.  The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment , 2012, International Psychogeriatrics.

[6]  M. Cantillon,et al.  Patient self-report for evaluating mild cognitive impairment and prodromal Alzheimer's disease , 2011, Alzheimer's Research & Therapy.

[7]  Anders Kottorp,et al.  Individual variability and environmental characteristics influence older adults' abilities to manage everyday technology , 2011, International Psychogeriatrics.

[8]  D. Devanand,et al.  Functional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease. , 2011, Archives of general psychiatry.

[9]  Louise Nygård,et al.  Technology and everyday functioning in people with intellectual disabilities: a Rasch analysis of the Everyday Technology Use Questionnaire (ETUQ). , 2011, Journal of intellectual disability research : JIDR.

[10]  Nick C Fox,et al.  The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease , 2011, Alzheimer's & Dementia.

[11]  J. Morris,et al.  The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease , 2011, Alzheimer's & Dementia.

[12]  Maria Larsson Lund,et al.  Perceived difficulties using everyday technology after acquired brain injury: Influence on activity and participation , 2010, Scandinavian journal of occupational therapy.

[13]  L Nygård,et al.  Ability to manage everyday technology: a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment , 2010, Disability and rehabilitation. Assistive technology.

[14]  D. Galasko,et al.  Functional evaluation distinguishes MCI patients from healthy elderly people — The ADCS/MCI/ADL scale , 2010, The Journal of Nutrition, Health & Aging.

[15]  Dan Mungas,et al.  Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. , 2009, Archives of neurology.

[16]  R. Woods,et al.  Subjective Memory Complaints and Awareness of Memory Functioning in Mild Cognitive Impairment: A Systematic Review , 2009, Dementia and Geriatric Cognitive Disorders.

[17]  Jae Won Chung,et al.  Impairment of Instrumental Activities of Daily Living in Patients with Mild Cognitive Impairment , 2009, Psychiatry investigation.

[18]  L. Nygård,et al.  Everyday Technology Use Questionnaire: Psychometric Evaluation of a New Assessment of Competence in Technology Use , 2009 .

[19]  Jin-Sup Eom,et al.  Characteristic Profiles of Instrumental Activities of Daily Living in Different Subtypes of Mild Cognitive Impairment , 2009, Dementia and Geriatric Cognitive Disorders.

[20]  Christian Sorg,et al.  Cognitive rehabilitation in patients with mild cognitive impairment , 2009, International journal of geriatric psychiatry.

[21]  B. Winblad,et al.  Perceived difficulty in everyday technology use among older adults with or without cognitive deficits , 2009, Scandinavian journal of occupational therapy.

[22]  C. Lyketsos,et al.  Mild cognitive impairment: searching for the prodrome of Alzheimer's disease , 2008, World psychiatry : official journal of the World Psychiatric Association.

[23]  F. Pasquier,et al.  Risk profiles for mild cognitive impairment and progression to dementia are gender specific , 2008, Journal of Neurology, Neurosurgery, and Psychiatry.

[24]  E. Londos,et al.  Effects of a Goal-Oriented Rehabilitation Program in Mild Cognitive Impairment: A Pilot Study , 2008, American journal of Alzheimer's disease and other dementias.

[25]  Tania Giovannetti,et al.  Characterization of Everyday Functioning in Mild Cognitive Impairment: A Direct Assessment Approach , 2008, Dementia and Geriatric Cognitive Disorders.

[26]  K. Tham,et al.  Functioning in everyday life after stroke: a longitudinal study of elderly people receiving rehabilitation at home. , 2007, Scandinavian journal of caring sciences.

[27]  T. Salthouse Implications of within-person variability in cognitive and neuropsychological functioning for the interpretation of change. , 2007, Neuropsychology.

[28]  Kevin J Black,et al.  The cognitive correlates of functional status: a review from the Committee on Research of the American Neuropsychiatric Association. , 2007, The Journal of neuropsychiatry and clinical neurosciences.

[29]  L. Nygård,et al.  The use of everyday technology by people with dementia living alone: Mapping out the difficulties , 2007, Aging & mental health.

[30]  R. Petersen,et al.  Revised Criteria for Mild Cognitive Impairment: Validation within a Longitudinal Population Study , 2006, Dementia and Geriatric Cognitive Disorders.

[31]  D. Harvey,et al.  MCI is Associated With Deficits in Everyday Functioning , 2006, Alzheimer disease and associated disorders.

[32]  Hilkka Soininen,et al.  Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study , 2006, The Lancet Neurology.

[33]  C. Fabrigoule,et al.  Restriction in complex activities of daily living in MCI , 2006, Neurology.

[34]  Joseph Sharit,et al.  Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE). , 2006, Psychology and aging.

[35]  Christian Sorg,et al.  Complex activities of daily living in mild cognitive impairment: conceptual and diagnostic issues. , 2006, Age and ageing.

[36]  B. Winblad,et al.  Measuring long term effects and changes in the daily activities of people with dementia. , 2006, The journal of nutrition, health & aging.

[37]  E. Strauss,et al.  Intraindividual Variability as a Marker of Neurological Dysfunction: A Comparison of Alzheimer's Disease and Parkinson's Disease , 2006, Journal of clinical and experimental neuropsychology.

[38]  H. Dodge,et al.  Cognitive impairment as a strong predictor of incident disability in specific ADL-IADL tasks among community-dwelling elders: the Azuchi Study. , 2005, The Gerontologist.

[39]  Holly Tuokko,et al.  Mild cognitive impairment and everyday functioning in older adults , 2005, Neurocase.

[40]  C. Jack,et al.  Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment , 2004, Journal of internal medicine.

[41]  R. Petersen Mild cognitive impairment as a diagnostic entity , 2004, Journal of internal medicine.

[42]  M. R. Espejo Applying the Rasch Model: Fundamental Measurement in the Human Sciences , 2004 .

[43]  Lars R. Bergman,et al.  Studying Individual Development in an Interindividual Context: A Person-Oriented Approach , 2002 .

[44]  Willem J. van der Linden,et al.  Book reviews: Applying the Rasch Model , 2001 .

[45]  S. MacDonald,et al.  Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults. , 2000, Neuropsychology.

[46]  D. Wade,et al.  Inter-rater reliability of the Frenchay Activities Index in patients with stroke and their carers , 2000 .

[47]  R. Mayeux,et al.  Influence of education and occupation on the incidence of Alzheimer's disease. , 1994, JAMA.

[48]  S. Folstein,et al.  “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician , 1975 .

[49]  M. Carrillo,et al.  The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease , 2011 .

[50]  Patrizia Mecocci,et al.  Mild cognitive impairment: a systematic review. , 2007, Journal of Alzheimer's disease : JAD.

[51]  K. Coburn,et al.  The cognitive correlates of functional status , 2007 .

[52]  P. Emiliani Assistive Technology (AT) versus Mainstream Technology (MST): The research perspective , 2006 .

[53]  D. Wade,et al.  Inter-rater reliability of the Frenchay activities index in patients with stroke and their careers. , 2000, Clinical rehabilitation.

[54]  A. Kazdin Research design in clinical psychology, 3rd ed. , 1998 .

[55]  C. Skilbeck,et al.  An activities index for use with stroke patients. , 1983, Age and ageing.