{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:40:43Z","timestamp":1772804443687,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"FIPE\/HCPA","doi-asserted-by":"publisher","award":["471514\/2014-4"],"award-info":[{"award-number":["471514\/2014-4"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objectives: We aimed to compare performance-based functional ability and cognitive screening performance to determine the cortical thickness relationship in cognitively unimpaired (CN) elders, mild cognitive impairment (MCI) and dementia patients, as well as to compare performance-based and proxy-evaluated functional ability and to determine its cerebral white and gray matter correlates. Methods: In total, 22 CN, 32 MCI, and 21 dementia patients were included in this study. They underwent clinical, cognitive, and Magnetic Resonance Imaging (MRI) assessment. Individuals were evaluated with the Mini-Mental State Examination (MMSE), the Rey Auditory Verbal Learning test (RAVLT), the Activities of Daily Living Questionnaire (ADL-Q) and the Direct Assessment of Functional Status-Revised (DAFS-R). Results: Higher ADL-Q scores were significantly associated with lower cortical thickness (bilateral temporoparietal regions, including the inferior temporal lobes and precuneus), p &lt; 0.05. The DAFS-R scale showed a relationship with greater cortical thickness across extensive regions of the bilateral frontal, parietal, and temporal cortices (p &lt; 0.05). MMSE presented a more focal association, primarily in canonical memory-related areas, including the medial and lateral temporal lobes and inferior parietal regions (p &lt; 0.05). Conclusions: Functional independence measured by ADL-Q was associated with frontal and parietal cortical thickness, while DAFS-R scores demonstrated a more diffuse evaluation of cortical atrophy. Additionally, performance-based functional abilities according to the DAFS-R appear to be a stronger marker of cortical thickness than ADL-Q and MMSE.<\/jats:p>","DOI":"10.3390\/brainsci16030295","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:22:14Z","timestamp":1772788934000},"page":"295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Performance-Based Functional Status Predicts Diffuse Cortical Atrophy in Alzheimer\u2019s Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-8131","authenticated-orcid":false,"given":"Renata","family":"Kochhann","sequence":"first","affiliation":[{"name":"Psychology Department, Post-Graduate Program in Psychology, Human Cognition, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil"},{"name":"Memory Center, Hospital Moinhos de Vento, Porto Alegre 90560-032, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Ferreira","family":"da Silva","sequence":"additional","affiliation":[{"name":"Psychology Department, Post-Graduate Program in Psychology, Human Cognition, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eelco","family":"van Duinkerken","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Amsterdam University Medical Centers,  Vrije Universiteit, 1081 HV Amsterdam, The Netherlands"},{"name":"Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8648-4234","authenticated-orcid":false,"given":"Maila Rossato","family":"Holz","sequence":"additional","affiliation":[{"name":"Psychology Department, Post-Graduate Program in Psychology, Human Cognition, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia Lorena Fagundes","family":"Chaves","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Porto Alegre 90035-903, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9282-0601","authenticated-orcid":false,"given":"Wyllians Vendramini","family":"Borelli","sequence":"additional","affiliation":[{"name":"Memory Center, Hospital Moinhos de Vento, Porto Alegre 90560-032, Brazil"},{"name":"Department of Morphological Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90010-150, Brazil"},{"name":"Graduate Program in Biological Sciences: Pharmacology and Therapeutics (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90010-150, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochele Paz","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Psychology Department, Post-Graduate Program in Psychology, Human Cognition, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil"},{"name":"Medicine Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31270-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s00234-021-02767-y","article-title":"Right Entorhinal Cortical Thickness Is Associated with Mini-Mental State Examination Scores from Multi-Country Datasets Using MRI","volume":"64","author":"Yamashita","year":"2022","journal-title":"Neuroradiology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Yao, Z., Hu, B., Liang, C., Zhao, L., Jackson, M., and Alzheimer\u2019s Disease Neuroimaging Initiative (2012). 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