biostudies-literatureDevanand DPNIA NIH HHS55-61https://www.ebi.ac.uk/biostudies/studies/S-EPMC5321859biostudies-literatureUnknown31(1)The utility of functional deficits in patients with mild cognitive impairment is not established.In 3886 individuals with mild cognitive impairment evaluated and followed at 34 National Alzheimer Coordinating Center sites, informant-reported Pfeffer Functional Activities Questionnaire (FAQ) items associated with progression to dementia were derived in a training set (n=1943) and tested in the validation set (n=1943).In the training set, the optimal combination comprised 6 FAQ items (FAQ6): difficulties with finances (2 items), remembering events/appointments, playing games of skill, current events, and travel. In the validation set, hazard ratio for dementia increased from 2.00 for 1 FAQ6 deficit to 5.56 for 6 FAQ6 deficits. In patients 50 to 67 years old with high Mini Mental State Exam scores, dementia risk rose from 12.06% for no FAQ6 deficits to 56.75% for 6 functional deficits. Likelihood of progression to dementia reached 80% to 89% in older age groups with low Mini Mental State Exam and severe FAQ6 deficits.Specific functional deficits increased dementia risk and, with age and global cognition, constituted a validated clinical algorithm to estimate dementia risk. Clinicians can use this clinically important algorithm to personalize decision-making about further investigation and identify high-risk patients for early treatment or inclusion in clinical trials.Alzheimer disease and associated disordersImpact of Functional Deficits in Instrumental Activities of Daily Living in Mild Cognitive Impairment: A Clinical Algorithm to Predict Progression to Dementia.PMC5321859P30 AG013846P30 AG028383P30 AG008017P30 AG010133P50 AG005146P50 AG033514P50 AG005681P50 AG005142R01 AG017761R01 AG041795P30 AG019610P50 AG023501P30 AG008051P30 AG010129P30 AG013854P01 AG007232P50 AG005138P50 AG008702P30 AG010124P50 AG005134P30 AG012300P50 AG025688U01 AG016976P50 AG005136P30 AG035982P30 AG010161P50 AG005131P50 AG005133P50 AG016574P50 AG016573P50 AG016570Liu XDevanand DPBrown PJfalseImpact of Functional Deficits in Instrumental Activities of Daily Living in Mild Cognitive Impairment: A Clinical Algorithm to Predict Progression to Dementia.The utility of functional deficits in patients with mild cognitive impairment is not established.In 3886 individuals with mild cognitive impairment evaluated and followed at 34 National Alzheimer Coordinating Center sites, informant-reported Pfeffer Functional Activities Questionnaire (FAQ) items associated with progression to dementia were derived in a training set (n=1943) and tested in the validation set (n=1943).In the training set, the optimal combination comprised 6 FAQ items (FAQ6): difficulties with finances (2 items), remembering events/appointments, playing games of skill, current events, and travel. In the validation set, hazard ratio for dementia increased from 2.00 for 1 FAQ6 deficit to 5.56 for 6 FAQ6 deficits. In patients 50 to 67 years old with high Mini Mental State Exam scores, dementia risk rose from 12.06% for no FAQ6 deficits to 56.75% for 6 functional deficits. Likelihood of progression to dementia reached 80% to 89% in older age groups with low Mini Mental State Exam and severe FAQ6 deficits.Specific functional deficits increased dementia risk and, with age and global cognition, constituted a validated clinical algorithm to estimate dementia risk. Clinicians can use this clinically important algorithm to personalize decision-making about further investigation and identify high-risk patients for early treatment or inclusion in clinical trials.2017-01-01T00:00:00Z2017 Jan-Mar2020-10-29T09:56:25Z2019-03-27T02:37:09ZS-EPMC53218592781984310.1097/WAD.000000000000016010.1097/wad.0000000000000160