경도인지장애 환자에서 복합-일상활동의 제한

Restriction of Instrumental Activities of Daily Living in MCI

Objectives：Mild cognitive impairment (MCI) is distinguished from mild dementia by an absence of global intellectual deterioration and the preservation of activities of daily living (ADL). Recently, however, it became apparent that impairment of instrumental activities of daily living (IADL) is present before the threshold of dementia is reached. Thus, we want to examine whether IADL are impaired in patients with MCI, and which items of IADL are particularly involved. We divided the MCI group into amnestic (aMCI) and non-amnestic MCI (naMCI), and compared to the cognitively normal controls. In this study, we focused on the instrumental activities of daily living (IADL). Methods：The sample consisted of 69 community-dwelling older adults from a welfare center for the aged in Korea. The subjects were divided into three diagnostic groups; aMCI [N=19, memory domains below -1.5 standard deviation (SD)], naMCI (N=19, other cognitive domains below -1.5 SD, except memory domains) and cognitive normal controls (N=31). Subjects were assessed both on IADL and the cognitive function. In order to assess the IADL, we used the Seoul -Instrumental Activities of Daily Living (S-IADL). Included measures of cognitive tests are as follows；Seoul Verbal Learning Test (SVLT), Rey Complex Figure Test (RCFT), Korean-Boston Naming Test (K-BNT), Stroop test, and Korean-Mini Mental Status Examination (K-MMSE). Groups were compared on the S-IADL and the cognitive tests. Results：The three groups did not differ in the mean age, gender distribution and years of education. S-IADL were shown to be different between the groups in this study. Subjects with aMCI were significantly more impaired in S-IADL in comparison to the controls [F(2,50)= 4.251, p=0.020]. And on four items of S-IADL (shopping, transportation, medication and talking about recent events), subjects with aMCI showed higher impairment compared to the controls. However, the S-IADL did not differ between the subjects with naMCI and controls. Conclusion：In this study, impairment of S-IADL was shown in subjects with aMCI. And S-IADL of naMCI was not significantly differed from aMCI and controls. The results suggest that naMCI would be distinguished from aMCI in characteristics and prognosis.