Predictors of functional disability in mild cognitive impairment and dementia

Abstract

Objective Knowledge about factors predicting functional disability in mild cognitive impairment (MCI) and dementia would help health care providers to identify those patients who are at high risk of functional disability. Previous research is scarce and focused on only a small number of possible predictors. The aim of this study was to identify predictors of functional disability in patients with MCI and dementia. Study design Cross-sectional cohort study. Main outcome measures Data from patients who visited a memory clinic between 2011 and 2015 were evaluated. The Disability Assessment for Dementia (DAD) was used to assess functional disability. Patients diagnosed with MCI or dementia and with a DAD score available were included. This led to the inclusion of 474 patients. Univariate analyses with a broad range of variables were performed to detect factors that had a significant relationship to the DAD score. Age, gender and variables with a p-value of 0.1 or lower in the univariate analyses were taken into a multivariable analysis. This multiple linear regression analysis was performed to determine which variables were independently associated with the DAD score. Main results Our multivariable model explained 42% of the variance in the DAD score. Independent predictors of the DAD score were age (B = 0.03, 95%CI = 0.002–0.05), gender (B = −0.43, 95%CI = −0.78 to −0.07), score on the Clinical Dementia Rating scale (CDR) (B = 1.53, 95%CI = 1.07–1.99 for CDR 1, B = 2.93, 95%CI = 2.28–3.58 for CDR 2, B = 3.96, 95%CI = 2.65–5.27 for CDR 3) and level of physical activity (B = 0.56, 95%CI = 0.05–1.07). Conclusion Older age, male gender, higher CDR score and lower levels of physical activity are independent predictors of functional disability in MCI and dementia.