DECREASED PHYSICAL HEALTH AND ENVIRONMENTAL DOMAINS OF QUALITY OF LIFE (WHOQOL-BREF) IN MILD COGNITIVE IMPAIRMENT: IMPLICATIONS FOR GENDER-DIFFERENT EARLY DETECTION IN THE COMMUNITY–THE TOME PROJECT

According to our previous study, older adults with mild cognitive impairment (MCI) showed subjective complaints on disturbed social activity (JGPN 2004) and impaired instrumental activities of daily living (ADL) only in women (AAIC 2011). Especially in men, such disturbed social activities were suspected to be associated with impaired quality of life (QOL). The World Health Organization QOL (WHOQOL-BREF) questionnaire is a test to assess an international cross-culturally-comparable QOL for healthy, MCI and dementia, consisting of Physical, Psychological, Social, and Environmental domains. Our aim was to investigate how QOL was affected by MCI people in the community. One hundred eighty-six community dwellers aged 75+ years living in Tome city, Northern Japan, agreed to participate in our study; 67 (32 male and 35 female) scored a Clinical Dementia Rating (CDR) of 0 (healthy), 89 (34 and 55) scored a CDR of 0.5 (MCI) and 30 (14 and 16) scored a CDR of 1+ (dementia). The objective variables were the total and subscales of the WHOQOL-BREF, and the Geriatric Depression Scale (GDS). Two-way analysis of variance (ANOVA) (3 CDR * 2 gender) showed main effects of CDR (p < 0.005) in the total WHOQOL-BREF, Physical, Psychological domains, and gender (p <0.05) in Social domain. Furthermore, there were significant interactions of CDR and gender (p<0.05) for the total and all subscales of the WHOQOL-BREF and the GDS. In Bonferroni's correction as a post hoc test, in men, the CDR 0.5 group showed lower scores on Physical and Environment, however, Physical and Social domains were maintained. Conversely, no differences were found for all domains in women. Our results suggest that elderly men with MCI have subjective complaints of poor physical health and socio-cultural activity, contrary to women's objectively apparent IADL disability without subjective complaints. Such socio-cultural problems are important for early detection of MCI people in the community.