Mild Functional Impairment (MFI): Definition of a Transversal Construct and Development of the MFI-3D Checklist.

 

Background

The defined MFI construct is aimed at the early assessment of mild functional changes that could be related to neurodegenerative diseases, aging, and a higher incidence of other pathologies. This transversal construct 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. MFI es defined as “a decline in functionality from previous level, secondary to a mild decrease in physical and/or cognitive and/or psychological capabilities, such as it does not involved either a loss of autonomy or supervened dependency on others”. The MFI construct is only relevant to adults and not disease-related. The functional decline must be present for, at least, 12 months and allows for minimal health for support personal autonomy.

 

Objective

To operationalize the MFI criteria into a functional assessment tool and establish its preliminary validity.

 

Methods

A modified Delphi process was conducted with twenty-two multidisciplinary experts from the International MFI Working Group, spanning Neurology, Geriatrics, Psychiatry, and Neuropsychology. Through an iterative process, the panel agreed upon a structure reflecting three dimensions of function (planning, motivation, and movement) across five domains: daily life, technology, travel/transportation, finance, and household affairs. This structure was operationalized into a digital checklist requiring dichotomic (yes/no) responses, where affirmative answers unfold the dimensional evaluation.

 

Results

We present the Mild Functional Impairment 3D Checklist (MFI-3D), a 17-item digital instrument for the evalution of mild functional changes, which can easily be completed by a patient, close informant, professional or both.

Last, we advance further steps in the MFI conceptual and psychometric research, with special stress on its validation in diverse population groups. 

 

Conclusion

MFI is intended to detect mild changes in functional abilities, either related to neurodegenerative diseases, aging or other no-neurodegenerative diseases. The MFI-3D checklist provides a measure tool specifically developed to assess this mild functional changes. Its state of the art psychometric design allows for multiple domains and perspectives; it is self-relative-professional administered;  and yields robust quantification.