Performance on the Texas Functional Living Scale (TFLS) In Mild Cognitive Impairment
Binegar, Dani Lyn
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Mild cognitive impairment (MCI) describes the transitional state between normal aging and dementia for many individuals, although debate continues over whether MCI represents an initial, separate condition, or if it is, in fact, the earliest presentation of dementia. One criterion for the diagnosis of MCI is an absence of impairment in activities of daily living; however, there is growing evidence that many individuals with MCI have difficulties with some instrumental activities of daily living (IADLs), such as managing finances and medications. The current study examined the performance of individuals diagnosed with MCI and normal control subjects (NC) on a brief, quantifiable measure of IADLs, the Texas Functional Living Scale (TFLS). Additional goals of this study were to examine how the TFLS relates to standard neuropsychological measures of global cognitive function, memory, language, executive functioning, and attention, and to determine whether performance on the TFLS declines over time in MCI. As predicted, the MCI sample (n = 30) scored significantly lower than the NC group (n = 30) on the TFLS total score (t (58) = 2.34, p = .011) and on the TFLS Memory subscale (t (58) = 3.29, p = .002). Performance on the TFLS was significantly correlated with performance on the MMSE (ρ = .26) and The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD; r = .37). Scores on the TFLS Memory and Communication subscales were also correlated with the CERAD total score (r = .45 and .22, respectively). Across all subjects, the TFLS was associated with standard measures of memory and language (ρ's = .22 to .31). Although the difference did not reach statistical significance, subgroups of MCI and NC were followed over time, and 50% of individuals with MCI declined on the TFLS, compared with 29% of NC sample. These findings suggest that subtle changes in cognitive-related IADLs may be present in individuals with MCI, and that the TFLS is sensitive to such changes.