Affiliations: [a] Department of Neurology, University Clinic Hospital of Salamanca, Salamanca, Spain
| [b] Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
| [c] Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| [d] Department of Medicine, Complutense University, Madrid, Spain
| [e] Department of Psychooncology, Leicestershire Partnership Trust and University of Leicester, Leicester, UK
| [f] Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
Correspondence:
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Correspondence to: Julián Benito-León, MD, PhD, Avda. de la Constitución 73, portal 3, 7° Izquierda, E-28821 Coslada, Madrid, Spain. [email protected]
Abstract: Background:Specific cognitive alterations could be one of the predictors that lead to the complex activities of daily living (CADL) impairment in mild cognitive impairment (MCI) and, hence, help to explain the continuum between MCI and dementia. Objective:We aimed to reevaluate the existing uncertainty regarding the impact of memory and executive functions on CADL in patients with MCI. Methods:Caregivers of 161 patients with amnestic multi-domain MCI and of 150 patients with incipient Alzheimer’s disease as well as 100 age-, sex-, and education-matched controls, completed the Interview for Deterioration in Daily Living Activities in Dementia, a suitable instrument for the description and discrimination of CADL. In addition, all patients and controls were assessed with a neuropsychological battery to measure explicit memory and executive functions performance. Results:Multiple regression analyses showed that in the group of patients with amnestic multi-domain MCI, 67.4% of the variability of the CADL impairment was explained by worse performance on executive functions tests (p < 0.0001) and 41.8% by different explicit memory components impairment (p < 0.0001). Further, in patients with incipient AD, 44.0% of the variability of CADL impairment was explained by worse performance on executive functions tests (p < 0.0001) and 39.9% by different explicit memory components worsening (p < 0.0001). Conclusions:Memory and executive functions alterations impact similarly on the CADL in both amnestic multi-domain MCI and incipient Alzheimer’s disease. Given the continuum that exists between both conditions, we conclude that CADL impairment may be an important early step in the evolution towards Alzheimer’s disease from amnestic multi-domain MCI.
Keywords: Alzheimer’s disease, amnestic multi-domain MCI, complex activities of daily living, executive functions, memory function
