gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

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Prediction of Incident Dementia: Impact of Impairment in Instrumental Activities of Daily Living and Mild Cognitive Impairment – Results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe)

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  • Tobias Luck - Department of Social Medicine, Occupational Health and Public Health, Public Health Research Unit & LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig
  • Melanie Luppa - Department of Social Medicine, Occupational Health and Public Health Research Unit, University of Leipzig, Leipzig
  • Birgit Wiese - Institute for Biometrics, Hannover Medical School, Hannover
  • Wolfgang Maier - Department of Psychiatry, University of Bonn, Bonn
  • Hendrik van den Bussche - Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg-Eppendorf
  • Steffi G. Riedel-Heller - Department of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds178

doi: 10.3205/11gmds178, urn:nbn:de:0183-11gmds1781

Published: September 20, 2011

© 2011 Luck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: There is an increasing call for a stronger consideration of impairment in instrumental activities of daily living (IADL) in the diagnostic criteria of Mild Cognitive Impairment (MCI) in order to improve the prediction of dementia. Thus, the aim of the study was to determine the impact of MCI and IADL impairment on incident dementia.

Methods: Data were derived from the German Study on Ageing, Cognition and Dementia in Primary Care Patients, a longitudinal study of GP patients aged 75 years and older. The impact of MCI and IADL impairment on incident dementia was analysed using Receiver Operating Characteristics, Kaplan-Meier survival analyses and Cox proportional hazards models.

Results: MCI and IADL impairment were found to be significantly associated with higher conversion to, shorter time to, and better predictive power for future dementia. Regarding IADL, a significant impact particularly was found for impairment in responsibility for one’s own medication, shopping, housekeeping, and in the ability to use public transport.

Conclusions: Combining MCI with IADL impairment significantly improves the prediction of future dementia. Even though information on a set of risk factors is required to achieve a predictive accuracy for dementia in subjects with MCI being clinically useful, IADL impairment should be a very important element of such a risk factor set.

Declaration of Interest: This publication is part of the German Research Network on Dementia (KND) and the German Research Network on Degenerative Dementia (KNDD) and was funded by the German Federal Ministry of Education and Research.