Functional significance of mild cognitive impairment in elderly patients without a dementia diagnosis

The authors investigated differences in functional ability among three grou ps of subjects who were not diagnosed with dementia. normal control (NC) su bjects (n = 35); Clinical Dementia Rating Scale (CDRS) score of 0 (minimal impairment; n = 26); and CDRS 0.5 (questionable dementia; n = 42). CDRS 0 a nd 0.5 patients reported significantly poorer functioning than NCs in house hold and other activities, but CDRS 0 and CDRS 0.5 groups did not differ in self-reported functioning. It is likely that CDRS 0.5 patients over estima ted their functional abilities. Correlations between self and informant rep orts of functional status were significantly lower in the CDRS 0.5 group th an in the CDRS 0 group, an important finding for clinical management becaus e patients with questionable dementia may actually be more impaired than th ey, admit. Informants' reports or standardized performance-based assessment should be considered in the clinical evaluation of such patients.