Dementia and Mild Cognitive Impairment: Assessment of Cognitive Functioning, Functional Autonomy, and Neuropsychiatric Symptoms.

The present protocol aims to evaluate several fundamental aspects related to dementia and Mild Cognitive Impairment (MCI). Specifically, the objective is to investigate cognitive functioning, the degree of impairment in autonomy in activities of daily living, and the presence of neuropsychiatric and mood disorders. Through this integrated perspective, the study seeks to promote improvements in clinical management and patient care, fostering more effective and personalized interventions. The primary objective of the study is to assess the level of functional autonomy in individuals affected by dementia or Mild Cognitive Impairment (MCI), with particular attention to both basic and instrumental activities of daily living, using the ADL and IADL scales. In addition to the main goal, the study aims to analyze the presence and extent of emotional and neuropsychiatric symptoms and to evaluate their impact on the overall psychological well-being of patients, using standardized psychometric tools that will be described in detail in later sections.

The study has an observational, retrospective design. Data will be collected from the neuropsychological assessments of patients who have undergone at least three testing sessions, approximately 12 months apart, at the Neuropsychology Outpatient Clinic of the IRCCS Centro Neurolesi Bonino Pulejo.

The sample size estimation was conducted in relation to the primary objective-evaluating the level of functional autonomy impairment in patients diagnosed with dementia or MCI, measured using the ADL and IADL scales. It was hypothesized that a mean difference of at least 1 point on the IADL scale between the two groups (patients with dementia vs. patients with MCI) would be clinically significant, assuming a standard deviation of 1.5, based on literature and clinical practice data. The statistical power was calculated using the G*Power software (version 3.1), selecting a two-tailed independent-samples t-test. Assuming an effect size (d) of 0.5, a significance level (α) of 0.05, and a statistical power (1-β) of 80%, the calculation indicated that at least 64 participants per group (MCI and dementia) would be required, for a total of 128 participants. Considering a potential dropout or loss to follow-up rate of 15%, an overall recruitment target of approximately 151 patients has been set. Participants will be recruited from the Neuropsychology Outpatient Clinic of the IRCCS Centro Neurolesi Bonino Pulejo in Messina.

Participants will be included in the study if, based on the available clinical documentation, they meet the following criteria:

• Age between 50 and 86 years;
• Suspected or confirmed diagnosis of dementia or Mild Cognitive Impairment (MCI), referred to the Neuropsychology Clinic for an initial evaluation or clinical monitoring;
• Absence of behavioral, psychiatric, or sensory disturbances severe enough to significantly compromise the performance of cognitive tests or the completion of questionnaires.