Introduction: There is a growing body of evidence that subtle deficits in instrumental activities of daily living (IADL) may be present in mild cognitive impairment (MCI). However, it is not clear if there are IADL domains that are consistently affected across patients with MCI. In this systematic review, therefore, we aimed to summarize research results regarding the performance of MCI patients in specific IADL (sub)domains compared with persons who are cognitively normal and/or patients with dementia. Methods: The databases PsycINFO, PubMed and Web of Science were searched for relevant literature in December 2013. Publications from 1999 onward were considered for inclusion. Altogether, 497 articles were retrieved. Reference lists of selected articles were searched for potentially relevant articles. After screening the abstracts of these 497 articles, 37 articles were included in this review. Results: In 35 studies, IADL deficits (such as problems with medication intake, telephone use, keeping appointments, finding things at home and using everyday technology) were documented in patients with MCI. Financial capacity in patients with MCI was affected in the majority of studies. Effect sizes for group differences between patients with MCI and healthy controls were predominantly moderate to large. Performance-based instruments showed slight advantages (in terms of effect sizes) in detecting group differences in IADL functioning between patients with MCI, patients with Alzheimer’s disease and healthy controls. Conclusion: IADL requiring higher neuropsychological functioning seem to be most severely affected in patients with MCI. A reliable identification of such deficits is necessary, as patients with MCI with IADL deficits seem to have a higher risk of converting to dementia than patients with MCI without IADL deficits. The use of assessment tools specifically designed and validated for patients with MCI is therefore strongly recommended. Furthermore, the development of performance-based assessment instruments should be intensified, as they allow a valid and reliable assessment of subtle IADL deficits in MCI, even if a proxy is not available. Another important point to consider when designing new scales is the inclusion of technology-associated IADL. Novel instruments for clinical practice should be time-efficient and easy to administer.

The medial prefrontal cortex (MPFC) appears to play a prominent role in two fundamental aspects of social cognition, that is, self-referential processing and perspective taking. However, it is currently unclear whether the same or different regions of the MPFC mediate these two interdependent processes. This functional magnetic resonance imaging study sought to clarify the issue by manipulating both dimensions in a factorial design. Participants judged the extent to which trait adjectives described their own personality (e.g., “Are you sociable?”) or the personality of a close friend (e.g., “Is Caroline sociable?”) and were also asked to put themselves in the place of their friend (i.e., to take a third-person perspective) and estimate how this person would judge the adjectives, with the target of the judgments again being either the self (e.g., “According to Caroline, are you sociable?”) or the other person (e.g., “According to Caroline, is she sociable?”). We found that self-referential processing (i.e., judgments targeting the self vs. the other person) yielded activation in the ventral and dorsal anterior MPFC, whereas perspective taking (i.e., adopting the other person's perspective, rather than one's own, when making judgments) resulted in activation in the posterior dorsal MPFC; the interaction between the two dimensions yielded activation in the left dorsal MPFC. These findings show that self-referential processing and perspective taking recruit distinct regions of the MPFC and suggest that the left dorsal MPFC may be involved in decoupling one's own from other people's perspectives on the self.