Changes in mobility among older adults with psychometrically defined mild cognitive impairment.

Studies have found that adults with possible mild cognitive impairment (MCI) exhibit decrements in everyday functioning (e.g., Wadley, V. G., Crowe, M., Marsiske, M., Cook, S. E., Unverzagt, F. W., Rosenberg, A. L., et al. (2007). Changes in everyday function among individuals with psychometrically defined mild cognitive impairment. Journal of the American Geriatrics Society, 55, 1192-1198). However, it is not known whether driving mobility and life space mobility are reduced in such individuals. The current study examined 5-year trajectories of mobility change in older adults (N = 2,355) with psychometrically defined MCI from the Advanced Cognitive Training for Independent and Vital Elderly trial. Mixed effect models evaluated group differences for the following mobility outcomes: driving space, life space, driving frequency, and driving difficulty. Relative to cognitively normal participants, participants with possible MCI showed reduced baseline mobility for all outcomes as well as faster rates of decline for driving frequency and difficulty. These results suggest that mobility declines could be features of MCI, and changes in mobility may be particularly important for researchers and clinicians to monitor in this population.

[1]  A M Jette,et al.  A Ten-Year Follow-Up of Driving Patterns among the Community-Dwelling Elderly , 1992, Human factors.

[2]  W. Jagust,et al.  Degree of discrepancy between self and other‐reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy elders , 2005, International journal of geriatric psychiatry.

[3]  Karlene K Ball,et al.  What predicts changes in useful field of view test performance? , 2008, Psychology and aging.

[4]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[5]  Hans-Werner Wahl,et al.  Aging independently : living arrangements and mobility , 2003 .

[6]  L. Radloff The CES-D Scale , 1977 .

[7]  B. Freund,et al.  Effects of cognition on driving involvement among the oldest old: variations by gender and alternative transportation opportunities. , 2002, The Gerontologist.

[8]  M. Crowe,et al.  Subjective cognitive function and decline among older adults with psychometrically defined amnestic MCI , 2006, International journal of geriatric psychiatry.

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

[10]  G. Papandonatos,et al.  Prediction of On‐Road Driving Performance in Patients with Early Alzheimer's Disease , 2005, Journal of the American Geriatrics Society.

[11]  J N Morris,et al.  ACTIVE: a cognitive intervention trial to promote independence in older adults. , 2001, Controlled clinical trials.

[12]  J. M. Lyman,et al.  Factors related to driving difficulty and habits in older drivers. , 2001, Accident; analysis and prevention.

[13]  J. Morris,et al.  Mild cognitive impairment as a clinical entity and treatment target. , 2005, Archives of neurology.

[14]  Jason Brandt,et al.  Everyday functioning in mild cognitive impairment and its relationship with executive cognition , 2010, International journal of geriatric psychiatry.

[15]  O. Okonkwo,et al.  Visual attention and self-regulation of driving among older adults , 2008, International Psychogeriatrics.

[16]  Quincy M. Samus,et al.  Predictors of functional impairment in residents of assisted-living facilities: the Maryland Assisted Living study. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  H. Feldman,et al.  Transition from Cognitively Impaired Not Demented to Alzheimer’s Disease: An Analysis of Changes in Functional Abilities in a Dementia Clinic Cohort , 2008, Dementia and Geriatric Cognitive Disorders.

[18]  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.

[19]  Janine G. Walker,et al.  Cognitive, sensory and physical factors enabling driving safety in older adults. , 2005, Clinical psychology review.

[20]  S. Anderson,et al.  Driver landmark and traffic sign identification in early Alzheimer’s disease , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[21]  R. Gansevoort,et al.  The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review , 2004 .

[22]  Beth T. Stalvey,et al.  Driving avoidance and functional impairment in older drivers. , 1998, Accident; analysis and prevention.

[23]  Ozioma C. Okonkwo,et al.  Awareness of Functional Difficulties in Mild Cognitive Impairment: A Multidomain Assessment Approach , 2009, Journal of the American Geriatrics Society.

[24]  R. Allman,et al.  Measuring Life‐Space Mobility in Community‐Dwelling Older Adults , 2003, Journal of the American Geriatrics Society.

[25]  R. Ownby,et al.  Using different memory cutoffs to assess mild cognitive impairment. , 2006, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[26]  Kaarin J Anstey,et al.  Predicting Driving Cessation over 5 Years in Older Adults: Psychological Well‐Being and Cognitive Competence Are Stronger Predictors than Physical Health , 2006, Journal of the American Geriatrics Society.

[27]  Karen Bandeen-Roche,et al.  Divided visual attention as a predictor of bumping while walking: the Salisbury Eye Evaluation. , 2004, Investigative ophthalmology & visual science.

[28]  Susan D. Vanderhill,et al.  Characterization of activities of daily living in individuals with mild cognitive impairment. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[29]  Karlene K Ball,et al.  Predictors of driving exposure and avoidance in a field study of older drivers from the state of Maryland. , 2006, Accident; analysis and prevention.

[30]  D. Harvey,et al.  Longitudinal Changes in Memory and Executive Functioning are Associated with longitudinal change in instrumental activities of daily living in older Adults , 2009, The Clinical neuropsychologist.

[31]  Lesley A Ross Does Speed of Processing Training Impact Driving Mobility in Older Adults , 2008 .

[32]  V. Wadley,et al.  Sensory and Cognitive Factors Influencing Functional Ability in Older Adults , 2005, Gerontology.

[33]  E. Steinhagen-Thiessen,et al.  Morbidity, medication, and functional limitations in very old age , 1999 .

[34]  G Rudinger,et al.  SELF-INITIATED COMPENSATIONS AMONG OLDER DRIVERS. IN: AGING INDEPENDENTLY. LIVING ARRANGEMENTS AND MOBILITY , 2003 .

[35]  Karlene K. Ball,et al.  Reliability and Validity of Useful Field of View Test Scores as Administered by Personal Computer , 2005, Journal of clinical and experimental neuropsychology.

[36]  J. Brandt The Hopkins Verbal Learning Test: Development of a new memory test with six equivalent forms. , 1991 .

[37]  H. Amièva,et al.  Incidence and outcome of mild cognitive impairment in a population-based prospective cohort , 2002, Neurology.

[38]  J. Jolles,et al.  Ten-year risk of dementia in subjects with mild cognitive impairment , 2006, Neurology.

[39]  K. Markides,et al.  Generational differences in the structure of the CES-D scale in Mexican Americans. , 1989, Journal of gerontology.

[40]  C. Fabrigoule,et al.  Disability and cognitive impairment in the elderly. , 1997, Disability and rehabilitation.

[41]  U S Nayak,et al.  The life-space diary: a measure of mobility in old people at home. , 1985, International rehabilitation medicine.

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

[43]  Gayla M. Cissell,et al.  Do older drivers at-risk for crashes modify their driving over time? , 2009, The journals of gerontology. Series B, Psychological sciences and social sciences.

[44]  O. Okonkwo,et al.  Mild cognitive impairment and everyday function: evidence of reduced speed in performing instrumental activities of daily living. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[45]  Karlene K Ball,et al.  The useful field of view test: normative data for older adults. , 2006, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

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

[47]  K. Boone,et al.  Handbook of Normative Data for Neuropsychological Assessment , 1999 .

[48]  Beth T. Stalvey,et al.  Older drivers and cataract: driving habits and crash risk. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[49]  H. Chiu,et al.  Characteristic Profiles of Instrumental Activities of Daily Living in Chinese Older Persons with Mild Cognitive Impairment , 2007, American journal of Alzheimer's disease and other dementias.

[50]  M. Schmitter-Edgecombe,et al.  Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. , 2009, Neuropsychology.

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

[52]  G McGwin,et al.  Visual risk factors for driving difficulty among older drivers. , 2000, Accident; analysis and prevention.

[53]  A J McLean,et al.  Self-regulation of driving and its relationship to driving ability among older adults. , 2006, Accident; analysis and prevention.

[54]  R. Dixon,et al.  Psychological compensation: a theoretical framework. , 1992, Psychological bulletin.

[55]  J. Allaire,et al.  Everyday cognition: age and intellectual ability correlates. , 1999, Psychology and aging.

[56]  O. Okonkwo,et al.  Mild Cognitive Impairment and Everyday Function: An Investigation of Driving Performance , 2009, Journal of geriatric psychiatry and neurology.

[57]  K. Wild,et al.  Longitudinal study of self-imposed driving restrictions and deficit awareness in patients with Alzheimer disease. , 1999, Alzheimer disease and associated disorders.

[58]  Jason C. Allaire,et al.  Mild Cognitive Impairment and Objective Instrumental Everyday Functioning: The Everyday Cognition Battery Memory Test , 2009, Journal of the American Geriatrics Society.

[59]  Cynthia Owsley,et al.  The Life Space Questionnaire: A Measure of the Extent of Mobility of Older Adults , 1999 .

[60]  P. Visser,et al.  Predictive Accuracy of MCI Subtypes for Alzheimer’s Disease and Vascular Dementia in Subjects with Mild Cognitive Impairment: A 2-Year Follow-Up Study , 2005, Dementia and Geriatric Cognitive Disorders.

[61]  Cynthia Owsley,et al.  Impact of cataract surgery on motor vehicle crash involvement by older adults. , 2002, JAMA.

[62]  M. Crowe,et al.  Changes in Everyday Function in Individuals with Psychometrically Defined Mild Cognitive Impairment in the Advanced Cognitive Training for Independent and Vital Elderly Study , 2007, Journal of the American Geriatrics Society.