Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Research Article Dement Geriatr Cogn Disord 2005;19:316–323 DOI: 10.1159/000084557 The Impact of Change in Cognitive Functioning and Cognitive Decline on Disability, Well-Being, and the Use of Healthcare Services in Older Persons Results of the Longitudinal Aging Study Amsterdam Hannie C. Comijs Miranda G. Dik Marja J. Aartsen Dorly J.H. Deeg Cees Jonker Institute for Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands Introduction With increasing life expectancy, the quality of life of older persons in our society has become an important is- sue. In older persons, quality of life is strongly affected by cognitive impairment because of diminishing capabilities and skills. Cognitive impairment is common in the older population, occurring in 16.8–26.6% of the general popu- lation of older persons [1–5]. Studies on the well-being of people with cognitive impairment have focused mainly on depression [6–8], with much less research on the as- sociation between cognitive impairment and loneliness [9, 10]. There has also been little reported on the impact of cognitive impairment on other measures of well-being, such as self-perceived health and symptoms of anxiety. It is generally acknowledged that, because of cognitive, emotional, and functional problems, moderately or se- verely demented persons need more help from healthcare services than persons not suffering from dementia. How- ever, it has also been shown that people with cognitive impairment, but no dementia, have significantly more difficulty in the performance of daily activities than per- sons without cognitive deficits [11–13] . As a consequence, Key Words Cognitive impairment  Cognitive decline  Disability  Well-being  Health care Abstract The study investigated the impact of change in cognitive functioning and cognitive decline on disability, well-be- ing, and the use of healthcare services among older per- sons in the Longitudinal Aging Study Amsterdam (LASA). Data were collected from 1,349 subjects, aged 65–85 years, who had scores of 24 and higher on the Mini-Men- tal State Examination (MMSE) at baseline, over a period of 6 years in three waves. The results indicate that cogni- tive decline and changes in cognitive functioning in old- er persons who were either not impaired or only mildly cognitively impaired at baseline have an impact on dis- ability, well-being, and the use of healthcare services. With the aging of the population, the number of persons with cognitive impairment is likely to increase, and ap- propriate services should be available to them. Copyright © 2005 S. Karger AG, Basel Accepted: November 1, 2004 Published online: March 22, 2005 Hannie C. Comijs VU University Medical Center, Faculty of Medicine/LASA Van der Boechorststraat 7 NL–1081 BT Amsterdam (The Netherlands) Tel. +31 20 4446770/4449327, Fax +31 20 4446775, E-Mail h.comijs@vumc.nl © 2005 S. Karger AG, Basel 1420–8008/05/0196–0316$22.00/0 Accessible online at: www.karger.com/dem