Patterns of functioning in older adults with mild cognitive impairment: a two-year study focusing on everyday technology use

Abstract

Objectives: Early detection is vital for persons with mild cognitive impairment (MCI) who are at risk of activity and participation limitations, and crosssectional studies suggest the ability to use everyday technology (ET) to be a sensible tool. However, group level analyses fail to inform us about how functioning can vary over time for individuals. This study aimed at exploring and describing patterns of functioning over two years in a sample newly classified with MCI, with a special focus on perceived difficulty in ET use and involvement in everyday activities. In addition, cognitive functioning and conversion to dementia were studied.

Method: 37 older adults (aged ≥ 55) with MCI were assessed at inclusion, and at 6, 12, and 24 months. Longitudinal case plots for the variables under study were analyzed based on strict criteria using a person-oriented approach. Paired t-tests from baseline and 24 months were also conducted to analyze change.

Results: The 32 participants who remained in the study after two years showed three distinct patterns of functioning over time: stable/ascending (n = 10), fluctuating (n = 10), and descending (n = 12), with the highest conversion to dementia in the descending pattern (58%). The perceived ability to use ET decreased or fluctuated in 50% of the sample. However, on a group level, a significant difference between baseline and 24 months was found only regarding cognitive function.

Conclusion: As the need for support is individual and likely to alter over time, repeated evaluations of activity involvement and difficulty in ET use are suggested to target timely interventions for persons with MCI.

Keywords:

• longitudinal studies
• activities of daily living
• self-assessment
• dementia

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Corrigendum

Acknowledgements

We are most grateful to the persons with MCI and their significant others who generously shared their experiences of involvement in everyday activities and ET use with us. We also wish to thank occupational therapists Brittmari Uppgard, Monica Pantzar, and Sofia Starkhammar who took part in data collection. The research was financially supported by the Doctoral School in Health Care Sciences, the Swedish Council for Working Life and Social Research (FAS), the Strategic Research Programme in Care Sciences at Karolinska Institutet, Swedish Brainpower, and the regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska Institutet.

Notes

Notes: ETUQ: Everyday Technology Use Questionnaire. Higher person measure indicates less difficulty in ET use (Nygård et al., 2012). FAI: Frenchay Activities Index (0–45). Higher score indicates more active lifestyle (Holbrook & Skilbeck, 1983). MMSE: Mini Mental State Examination (0–30). Higher score indicates better cognitive status (Folstein et al., 1975). Median (Md) and interquartile ranges (IQR) reported due to not normally distributed data in FAI and MMSE.

Notes: Regarding ETUQ, FAI, and MMSE as in notes of Table 1. df = 30, n = 31 due to missing data at 24-month follow-up for one participant. α set at 0.05.

Notes: Regarding ETUQ, FAI, and MMSE as in notes of Table 1 median (Md) and interquartile ranges (IQR) reported due to not normally distributed data.

¹ AD (n = 1)

² AD (n = 2)

³ AD (n = 5); AD, atypical or mixed (n = 1); unspecified dementia (n = 1)

⁴ MCI, subjective (n = 1); no known cognitive impairment (n = 1)

⁵ no known cognitive impairment (n = 1)