Mild functional impairment: Definition and diagnostic criteria

Introduction: The onset of mild functional impairment (MFI) is associated with greater progression to cognitive decline, in addition to influencing the course of other neurological, psychiatric, and geriatric diseases. To date, there is no clear definition of the MFI that may allow analysis of its impact.

Aim: To generate, through a multidisciplinary team and after a review of the scientific evidence, diagnostic criteria that can define the MFI construct.

Development: The criteria selected to define the construct which encompasses physical, cognitive, and behavioural aspects, and the process followed to select them, are described. An initial construct proposal was developed from the information extracted in the literature search, contextualised with clinical experience. For discussion, a questionnaire was developed that included, in addition to the proposed construct, 9 points on its content. The Delphi methodology was used to discuss the following points: the temporal occurrence of the proposed definition, age of application, persistence, type of activity affected (advanced, instrumental, basic activities of daily living), and, finally, the need for minimal aids to maintain autonomy. Finally, the next steps in the research of the concept and in the measurement of MFI, as well as future prospects, are proposed.

Conclusions: The defined construct is aimed at the early assessment of mild functional changes that could be related to neurodegenerative diseases, aging, and/or a higher incidence of other pathologies. This is intended to be the basis for the design of tools that allow for a more accurate assessment of the functionality of adult patients, thus complementing other clinical diagnoses.