Introduction
The Relation between Neuropsychological Deficits and IADL
Cross-Sectional Results
Longitudinal Results
The Relation between Brain Morphological Changes and Instrumental Activities of Daily Living
Interim Summary and Goal of the Present Review
Methods
Quality Assessment
Results
Authors sample characteristics | Functional scale | Cross sectional or longitudinal | Neuropsychological tests | Neuroanatomical correlates | Results |
---|---|---|---|---|---|
Bennett et al. 2002. 77 subcortical VaD patients (age 73.42, range 60–68) | IADL subscale of Lawton and Brody Informant-report
| Longitudinal, 6 years follow-up | MMSE/CDR/FAS/DF + DB + MC of WMS/Sum of 5 trails and trail 6 as a percentage of Trail 5 on RAVLT/Similarities and BD of WAIS-R/Percentage delayed recall of LM and VR of WMS/PM | CA VE NI Vol I LA
All visual, except VI which was volumetric
| DF and RAVLT trail 6 performance independently predicted IADL decline. No independent effect of neuroanatomical correlates was found. |
Bennett et al. 2006. 106 Community-living nondemented individuals (age 85.2 ± 2.9) | The Kilsyth Disability Rating Scale, and an interview to measure complex IADL Informant- and self-report
| Cross sectional | MMSE/DF + DB of WMS-R/BNT/SVFT/Oral TMT-B/LM + VR of WMS-R/Similarities of WAIS-R/Line Orientation Test/Copy of the cube drawing task/CES-D | PWML DWML HC Vol WBVol
PWML & DWML visual, rest volumetric
| DB and LM performance were related to cooking; Oral TMT-B with housework, and DF with shopping. DB and Similarities were related to Reading. Smaller left hippocampal volume was associated with less socializing (complex IADL). Uniqueness is assumed since no overlap is present between the neuroanatomical and neuropsychological correlates regarding individual IADLs. |
Boyle et al. 2003b. 29 VaD patients (age 78.0 ± 5.66) | IADL subscale of Lawton and Brody Informant-report
| Cross sectional | All subscales and total score of MDRS | SH CVol
Volumetric
| The I/P subscale of MDRS and SH independently contributed to the variance in IADLs. I/P alone accounted for 28 %, and SH accounted for 14 % beyond the contribution made by I/P. |
Boyle et al. 2004. 28 VAD patients (age 78.0 ± 5.7) | IADL subscale of Lawton and Brody Informant-report
| Longitudinal, 1 year follow-up | I/P subscale of MDRS/TMT-B/SCWT/MMSE | SH
Volumetric
| Baseline performance on executive tasks (MDRS I/P, SCWT) was a significant predictor of IADLs at the 1 year follow-up, explaining 50 % of the variance, even after accounting for global cognitive dysfunction (MMSE). SH did not explain unique variance in IADLs after accounting for executive dysfunction. |
Brown et al. 2011. N = 816 394 amnestic-MCI (age 74.84 ± 7.40) 193 AD patients (age 75.33 ± 7.48) 229 controls (age 75.90 ± 5.00) | Pfeffer Functional Activity Questionnaire (FAQ)
Informant-report for aMCI & AD, self-report for controls
| Cross sectional | TMT-A + B/DSym of WAIS-R/AVLT | HC Vol IBVol ECVol
Volumetric
| Within the aMCI group, total severity of IADL impairment and the total number of deficits was independently associated with hippocampal volume, AVLT 30-min delay and TMT-A scores; DSym was additionally associated with total severity score. In the combined aMCI and AD group, hippocampal volume and Trail Making Test, part A score independently predicted total and average severity of IADL impairment, as well as the number of deficits. In addition, AVLT 30-min delay score and entorhinal cortex volume independently predicted total severity and total number of deficits. These relations were not examined in the control group. |
Cahn et al. 1996. 30 elderly inpatients with major depression (age 75.5 ± 6.6) | A modified version of the Lawton & Brody IADL and Physical Self-Maintenance Scale. Total ADL score (PADL + IADL) was used
Informant-report
| Cross sectional | Immediate and delayed recall from the VR of WMS-R/Short and long delayed free recall of CVLT/SDMT/TMT-B/BNT/BCOWART/HVOT/RCFT/BCD/WCST/LGP | PVH DWMH WBA
Volumetric
| Neuropsychological test performance (NP Index, combining all tests), age, depression severity, and WMH (combined PVH & DWMH score) accounted for 53 % of the variance in ADL functioning. Severity of WMH accounted for an additional 18 % of the variance over and above the other 3 variables. The contribution of the NP Index was not significant. |
Cahn-Weiner et al. 2007. N = 124 52 controls (age 72.5 ± 7.4) 35 MCI (age 72.8 ± 8.4) 37 Dementia (age 73.1 ± 8.4) | Blessed Roth Dementia Rating Scale (BRDRS). Only the eight IADLs were analysed
Informant-report
| Cross sectional & longitudinal, 5 years follow-up | The memory composite (MEM): the MAS Word List Learning Test The executive composite score (EXEC): DB of WMS-R/VMSB of WMS-R/I/P subscale of MDRS/Letter Fluency/FAS | LAC WMH CGMVol HC Vol
Volumetric
| In the entire sample, baseline MEM and hippocampal volume were independently associated with baseline IADL scores. Only baseline EXEC independently predicted rate of decline in IADL scores. |
Chen et al. 2015. 66 AD patients with CVD (age 70.8 ± 10.7) | IADL scale of Lawton and Brody
Informant- report at follow-up
| Longitudinal, 6 months follow-up | MMSE | WML MTA VBR
WML & MTA visual, VBR volumetric
| WML and MMSE significantly predicted IADL both at baseline and at follow-up. |
Christman et al. 2010. N = 178 28 diabetics (age 66.39 ± 12.54) 150 non diabetics (age 63.43 ± 13.29) | IADL scale of Lawton and Brody
Informant- and self-report
| Cross sectional | MMSE/DSym + DS + BD + PC of WAIS-R/BTA/Speed test of SPCT/TMT-A + B/letter-, category-, design fluency/Information and Similarities of WAIS-R/IQ portion of NART/Copy of RCFT/BFRT/Learning trails (1–3) + delayed recall trail of HVLT-R/LM I + II of WMS-R/Learning trails (1–3) + delayed recall trail of BVMT-R/VR I + II of WMS-R/WCST-m | B-to-ICVol
Volumetric
| In the diabetic group, lower B-to-ICV ratio was not associated with IADLs. In this group, only working memory and speed were associated with IADL; since no association with B-to-ICV was found, some uniqueness can be assumed. In the non-diabetic group no significant associations were found between cognitive domains, B-to-ICV and functional activities. |
Griffith et al. 2010. N = 66 38 amnestic MCI (age 70.8 ± 6.4) 28 controls (age 71.6 ± 5.4) | Financial Capacity Instrument (FCI)
Performance-based
| Cross sectional | Spatial Span subtest of WMS-III/TMT-A/WRAT-3 Arithmetic subtest/MMSE | MFLVol AGVol HC Vol Pre. Vol
Volumetric
| In the amnestic MCI group, angular gyrus volume predicted the FCI scores after controlling for the MMSE. Separate mediation models indicated that Spatial Span and arithmetic ability partially mediated the relation between angular gyrus volume and FCI score. The effect of angular gyrus was marginally significant after controlling for Spatial Span; it was no longer significant controlling for arithmetic ability. These relations were not examined in the control group. |
Hybels et al. 2014. N = 377 237 depressed patients (age 69.5 ± 7.3) 140 controls (age 70.4 ± 6.3) | The Duke Depression Evaluation Schedule, IADL examined separately from BADL and mobility
Self-report
| Cross sectional | MMSE | WMLVol
Volumetric
| MMSE, but not WML volume, predicted IADL impairment in the entire sample. Also in the subsamples, WML volume did not predict IADL impairment, whereas the MMSE did. |
Inzitari et al. 2007. 619 elderly participants (age 74 ± 5) | IADL scale of Lawton and Brody
Informant-report
| Longitudinal, 1 year follow-up | ADAS-cognitive subscale | ARWMC
Visual
| The severity of ARWMCs significantly and independently predicts functional declining in a period of 1 year. Cognitive performance at baseline (ADAS-Cog) was an important factor underlying the effect of ARWMCs, but it is unclear whether cognition was also an independent significant predictor of IADL. |
Kochan et al. 2011. 30 MCI patients (age 78.3 ± 4.0) | Bayer Activities of Daily Living
Informant-based
| Longitudinal, 2 year follow-up | MMSE | HC Vol GMVol PMCVol
Volumetric
| No independent effects of MMSE or neuroimaging variables were found. |
Marshall et al. 2014. N = 812 229 controls (age 76.0 ± 5.0) 395 MCI (age 74.8 ± 7.5) 188 AD (age 75.3 ± 7.5) | Functional Activities Questionnaire (FAQ)
Self-report
| Cross sectional & longitudinal, 3 years follow-up | NART/RAVLT/DSym | Cortical thickness of: inferior temporal, supramarginal, precuneus, rostral anterior cingulate, medial orbitofrontal, rostral middle frontal, and lateral occipital cortices
Volumetric
| At baseline, worse DSym performance overall and decreased inferior temporal cortical thickness, increased lateral occipital cortical thickness in particularly AD patients predicted worse IADL. The unexpected effect of occipital thickness is likely due to multicollinearity. Lower baseline supramarginal cortical thickness and lower baseline inferior temporal cortical thickness predicted increased IADL decline. Additional linear level effects for precuneus cortical thickness and RAVLT were noted. |
Mok et al. 2004. N = 117 75 SSVD patients (age 71.0 ± 11.2) 42 controls (age 69.6 ± 9.9) | IADL subscale of Lawton and Brody
Self-report
| Cross sectional | ADAS-cognition/I/P subscale of MDRS/CDR/MMSE | NSSI SRSI WMC
Visual
| Stroke severity and executive dysfunction (MDRS I/P), but not neuroimaging, contribute independently to poor IADL. These analyses were not conducted in the control group. |
Steffens et al. 2002. 224 depressed adults (age > 60) | The Duke Depression Evaluation Schedule, IADL and BADL examined separately
Self-report
| Cross sectional | MMSE | WMLVol GMLVol
Volumetric
| MMSE independently predicted IADL, whereas WMLV and GMLV did not. |
Stoeckel et al. 2013. N = 32 16 AD patients (age 76.94 ± 8.16) 16 controls (age 75.0 ± 4.43) | Financial Capacity Instrument
Performance-based
| Cross sectional | MMSE, DRS-2 (dividing between attention, initiation/perseveration, construction, conceptualization, memory) | MFCVol Pre Vol DFCVol AGVol HC Vol
Volumetric
| DRS-2 Attention and Construction scores mediate the effect of MFCV on IADL. These analyses were not conducted for the control group. |
Taylor et al. 2003. N = 81 41 depressed elderly (age 68.73 ± 6.98) 40 controls (age 71.42 ± 6.07) | The Duke Depression Evaluation Schedule, IADL examined separately from BADL
Self-report
| Cross sectional | MMSE | TBVol TOFCVol
Volumetric
| In the entire sample, smaller OFC volumes and being depressed were significantly associated with IADL impairment. No unique contribution of MMSE scores was found. |
Verlinden et al. 2014. 2025 stroke-free nondemented adults (age 59.9 ± 7.0) | IADL scale of Lawton and Brody
Self-report
| Cross sectional & Longitudinal, mean 5,7 years follow-up | MMSE | BVol GMVol TWMVol HC Vol WMLVol LI Microbleeds FA Mean-; axial-; radial diffusivity
Volumetric
| After controlling for MMSE, smaller brain volume and smaller hippocampal volume was associated with larger deterioration in IADL. |
Vidoni et al. 2010. N = 114 56 controls (age 73.0 ± 6.2) 58 early AD (age 74.2 ± 6.3) | Alzheimer Disease Cooperative Study Activities of Daily Living Scale for Mild Cognitive Impairment (ADCS-ADL)
Informant-report
| Cross sectional | Global cognitive battery (COG) consisted of: LM IA + IIA of WMS-R/Free and Cued SRT/15 items of BNT/Letter - number sequencing of WAIS/DF + DB of WMSIII/TMT-A + B/SCWT/Verbal Fluency/BD of WAIS/MMSE | RGMA
Volumetric
| In demented subjects, reduced medial frontal cortex gray matter volume was a common substrate of both IADL and COG performance; in the non-demented subjects, the middle frontal and precentral cortex was the common substrate of IADL and COG performance. |