Early warnings signs may signal presence of mild cognitive impairment

Difficulties in performing more challenging cognitive tasks, such as managing one’s finances and medications, preparing meals and traveling independently, could be early warning signs that indicate the presence of mild cognitive impairment (MCI), according to Emory University researchers. Other more basic and well-rehearsed daily tasks, such as bathing, grooming, and dressing, can also decline in patients with MCI, but to a lesser extent. The findings will be presented at the 9th International Conference of Alzheimer’s Disease and Related Disorders in Philadelphia on July 18 at 8 a.m.

MCI is a term described as a subtle decline in thinking abilities. A person with MCI, for example, may experience memory problems greater than normally expected with aging, but that person does not show other symptoms of dementia, such as impaired judgment or reasoning, according to the Alzheimer’s Association.

Little research has been conducted on whether well-rehearsed activities of daily living, known as ADLs (feeding, dressing, grooming, walking, bathing and toileting) and instrumental activities of daily living, known as IADLs, (laundry, shopping, transportation, driving, meal preparation, managing medications and finances) are compromised early in the disease process.

Therefore, Emory researchers, led by Felicia Goldstein, PhD, associate professor of neurology at Emory University School of Medicine, looked at the decline in ADLs and IADLs in patients with MCI, compared to a group of patients with Alzheimer’s disease (AD) and a control group. Researchers retrospectively reviewed the histories of 96 patients over a six-month period who filled out questionnaires during an evaluation with a neurologist specializing in the diagnosis and treatment of AD and MCI.

“We found that while less impaired than those diagnosed with Alzheimer’s disease, patients with MCI demonstrated a compromised ability to perform IADLs when compared to the control group (no cognitive impairment),” says Dr. Goldstein. “Therefore we are learning that it is critical for physicians to take note of any decline of IADLs during neurological exams. These markers of decline are important so early drug intervention and family education and counseling can begin.”

There was also a trend for MCI patients to show some difficulties in activities of daily living, although not as significant as AD patients.

According to Dr. Goldstein, 12 to 18 percent of patients with MCI develop Alzheimer’s disease each year. “If we can recognize the early onset of MCI, we can start patients on medications immediately and keep them as independent as possible for as long as possible,” Dr. Goldstein explains.