The Cognitive Scale of Basic and Instrumental Activities of Daily Living for Multidomain Mild Cognitive Impairment and Dementia Patients: Validation of its Extended Version

This research was supported by the Spanish Ministry of Science and Innovation through a PhD research fellowship awarded to the last author (FPI BES-2009-020741), the Regional Government of Andalusia, Spain, through a research project granted to the second and last authors (Junta de Andalucía SEJ-6351) and the Fundación para la Investigación Biosanitaria de Andalucía Oriental – Alejandro Otero, a foundation for biomedical research in Eastern Andalusia, through a scholarship granted to the first author. Funding for open access charge: University of Málaga.Objective: To validate an informant-based tool – the extended version of the Cognitive Scale of Basic and Instrumental Activities of Daily Living (BADL and IADL) or Ext. Cog-ADL Scale – in a larger sample and with a broader range of cognitive-functional items related to activities of daily living (ADL). Method: The Ext. Cog-ADL Scale was administered to family informants of 42 patients with dementia, 43 patients with multidomain mild cognitive impairment (mdMCI), and 23 healthy control participants. We analyzed the convergent and concurrent validity and external validity of this scale. Results: The Ext. Cog-ADL Scale demonstrated good psychometric properties. Episodic and working memory tests were the main predictors of most cognitive-functional items of the scale. While patients with dementia obtained lower scores in most error categories of the scale, affecting both BADL and IADL, mdMCI patients showed a more specific pattern of difficulties. Apart from the typical alterations in IADL, mdMCI patients also showed difficulties in several error categories related to BADL (i.e., error detection, problem solving, task self-initiation, distraction inhibition, and restore). Conclusions: The Ext. Cog-ADL Scale seems to be an adequate tool to capture the specific pattern of cognitive alterations related to IADL and BADL that differentiates dementia from mdMCI and healthy aging; it shows that mdMCI can involve specific cognitive difficulties that affect even BADL.Spanish Ministry of Science and Innovation (FPI BES-2009-020741)Regional Government of Andalusia, Spain (Junta de Andalucía SEJ-6351)Fundación para la Investigación Biosanitaria de Andalucía Oriental – Alejandro OteroUniversity of Málag

The Cognitive Scale of Basic and Instrumental Activities of Daily Living for Multidomain Mild Cognitive Impairment and Dementia Patients: Validation of its Extended Version

The Ext. Cog-ADL Scale demonstrated good psychometric properties. Episodic and working memory tests were the main predictors of most cognitive-functional items of the scale. While patients with dementia obtained lower scores in most error categories of the scale, affecting both BADL and IADL, mdMCI patients showed a more specific pattern of difficulties. Apart from the typical alterations in IADL, mdMCI patients also showed difficulties in several error categories related to BADL (i.e., error detection, problem solving, task self-initiation, distraction inhibition, and restore).This research was supported by the Spanish Ministry of Science and Innovation through a PhD research fellowship awarded to the last author (FPI BES-2009-020741), the Regional Government of Andalusia, Spain, through a research project granted to the second and last authors (Junta de Andalucía SEJ-6351) and the Fundación para la Investigación Biosanitaria de Andalucía Oriental – Alejandro Otero, a foundation for biomedical research in Eastern Andalusia, through a scholarship granted to the first author. Funding for open access charge: University of Málaga

Preliminary cognitive scale of basic and instrumental activities of daily living for dementia and mild cognitive impairment.

In the present study we explored cognitive and functional deficits in patients with multidomain mild cognitive impairment (MCI), patients with dementia, and healthy age-matched control participants using the Cognitive Scale for Basic and Instrumental Activities of Daily Living, a new preliminary informant-based assessment tool. This tool allowed us to evaluate four key cognitive abilities—task memory schema, error detection, problem solving, and task self-initiation—in a range of basic and instrumental activities of daily living (BADL and IADL, respectively). The first part of the present study was devoted to testing the psychometric adequateness of this new informant-based tool and its convergent validity with other global functioning and neuropsychological measures. The second part of the study was aimed at finding the patterns of everyday cognitive factors that best discriminate between the three groups. We found that patients with dementia exhibited impairment in all cognitive abilities in both basic and instrumental activities. By contrast, patients with MCI were found to have preserved task memory schema in both types of ADL; however, such patients exhibited deficits in error detection and task self-initiation but only in IADL. Finally, patients with MCI also showed a generalized problem solving deficit that affected even BADL. Studying various cognitive processes instantiated in specific ADL differing in complexity seems a promising strategy to further understand the specific relationships between cognition and function in these and other cognitively impaired populations