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Raimo S, Maggi G, Ilardi CR, Cavallo ND, Torchia V, Pilgrom MA, Cropano M, Roldán-Tapia MD, Santangelo G. The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis. Neurol Sci 2024; 45:2427-2443. [PMID: 38347298 DOI: 10.1007/s10072-024-07366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/25/2024] [Indexed: 05/12/2024]
Abstract
Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy.
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
| | - Gianpaolo Maggi
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | - Ciro Rosario Ilardi
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | | | - Valentina Torchia
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | | | - Maria Cropano
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | | | - Gabriella Santangelo
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
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Liu C, Li L, Pan W, Mao P, Ren L, Li B, Ma X. Executive function deficits in patients with the first episode of late-life depression before and after SSRI treatment: A pilot fMRI study. Int J Geriatr Psychiatry 2024; 39:e6095. [PMID: 38687081 DOI: 10.1002/gps.6095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Executive function deficits (EFD) in late-life depression (LLD) has been reported to be associated with antidepressant treatment resistance, increased disability, and poor quality of life. However, the underlying neutral mechanisms of EFD in patients with the first episode of LLD remains unclear. METHODS A total of 27 patients with first-episode, drug-naive LLD and 27 non-depressed controls (NC) were recruited for the present research. Participants underwent the Trail Making Test, the 17-item Hamilton depression rating scale (HAMD-17) test, and task-state functional magnetic resonance imaging scans under the neutral Stroop task. LLD patients' executive functions, depressive symptoms, and brain activity were examined again after 6 months of antidepressant treatment. RESULTS Of the 27 LLD patients, 16 cases completed 6-month follow-ups. Patients in the LLD baseline group spent more time on the Trail Making Test A test than those in the NC group (p < 0.05). In the presence of an incongruency between the word color and meaning, the accuracy rate of the neutral Stroop task in the LLD baseline group was lower, and the reaction time was greater than that in the NC group, with statistically significant difference (p < 0.05). The HAMD-17 score in the LLD follow-up group was significantly lower than that in the LLD baseline group (p < 0.05). More activated brain regions were present in the LLD baseline group than in the NC group when performing the neutral Stroop task. Compared with the LLD baseline group, abnormal activation of relevant brains in the cingulate-prefrontal-parietal network of LLD patients still existed in the LLD follow-up group. CONCLUSIONS LLD patients engaged more brain areas than the NC group while performing the neutral Stroop task. Abnormal activation of the cingulate-prefrontal-parietal network could be a contributing factor to EFD in LLD. TRIAL REGISTRATION ChiCTR, ChiCTR2100042370 (Date of registration: 21/01/2021). LIMITS We didn't enroll enough first-episode, LLD patients, the robustness of the findings need to be confirmed by large sample clinical trials.
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Affiliation(s)
- Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weigang Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Peixian Mao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Bing Li
- Hebei Provincial Mental Health Center, Baoding, China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, China
- The Sixth Clinical Medical College of Hebei University, Baoding, China
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Ridgely NC, Woods SP, Webber TA, Mustafa AI, Evans D. Cognitive Intra-individual Variability in the Laboratory Is Associated With Greater Executive Dysfunction in the Daily Lives of Older Adults With HIV. Cogn Behav Neurol 2024; 37:32-39. [PMID: 37871277 PMCID: PMC10948322 DOI: 10.1097/wnn.0000000000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/30/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Executive dysfunction, which is common among persons with HIV (PWH), can have an adverse impact on health behaviors and quality of life. Intra-individual variability (IIV) is a measure of within-person variability across cognitive tests that is higher in PWH and is thought to reflect cognitive dyscontrol. OBJECTIVE To assess whether cognitive IIV in the laboratory is associated with self-reported executive dysfunction in daily life among older PWH. METHOD Participants included 71 PWH aged ≥50 years who completed six subtests from the Cogstate battery and two subscales from the Frontal Systems Behavior Scale (FrSBe; self-report version). Cognitive IIV was calculated from the Cogstate as the coefficient of variation derived from age-adjusted normative T scores. RESULTS Cognitive IIV as measured by the Cogstate showed a significant, positive, medium-sized association with current FrSBe ratings of executive dysfunction but not disinhibition. CONCLUSION Higher cognitive IIV in the laboratory as measured by the Cogstate may be related to the expression of HIV-associated symptoms of executive dysfunction in daily life for older PWH.
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De Vito AN, Ju CH, Lee SY, Cohen AK, Trofimova AD, Liu Y, Eichten A, Hughes A. Cognitive dispersion is related to subtle objective daily functioning changes in older adults with and without cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12539. [PMID: 38312515 PMCID: PMC10835082 DOI: 10.1002/dad2.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/04/2023] [Accepted: 01/02/2024] [Indexed: 02/06/2024]
Abstract
Early detection of cognitive and functional decline is difficult given that current tools are insensitive to subtle changes. The present study evaluated whether cognitive dispersion on neuropsychological testing improved prediction of objectively assessed daily functioning using unobtrusive monitoring technologies. Hierarchical linear regression was used to evaluate whether cognitive dispersion added incremental information beyond mean neuropsychological performance in the prediction of objectively assessed IADLs (i.e., computer use, pillbox use, driving) in a sample of 104 community-dwelling older adults without dementia (Mage = 74.59, 38.5% Female, 90.4% White). Adjusting for age, sex, education, and mean global cognitive performance, cognitive dispersion improved prediction of average daily computer use duration (R2 Δ = 0.100, F Change, p = 0.005), computer use duration variability (R2 Δ = 0.089, F Change p = 0.009), and average daily duration of nighttime driving (R2 Δ = 0.072, F Change p = 0.013). These results suggest cognitive dispersion may improve prediction of objectively assessed functional changes in older adults without dementia.
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Affiliation(s)
- Alyssa N. De Vito
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Memory and Aging ProgramButler HospitalProvidenceRhode IslandUSA
| | - Catherine H. Ju
- Department of PsychologyWest Virginia UniversityMorgantownWest VirginiaUSA
| | - Samuel Y. Lee
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Anael Kuperwajs Cohen
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of Minnesota Twin CitiesMinneapolisMinnesotaUSA
- Minneapolis VA Healthcare SystemMinneapolisMinnesotaUSA
| | - Alexandra D. Trofimova
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of Minnesota Twin CitiesMinneapolisMinnesotaUSA
- Minneapolis VA Healthcare SystemMinneapolisMinnesotaUSA
| | - Yan Liu
- School of Public HealthOregon Health & Science University‐Portland State UniversityPortlandOregonUSA
| | - Alyssa Eichten
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of Minnesota Twin CitiesMinneapolisMinnesotaUSA
- Minneapolis VA Healthcare SystemMinneapolisMinnesotaUSA
| | - Adriana Hughes
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of Minnesota Twin CitiesMinneapolisMinnesotaUSA
- Minneapolis VA Healthcare SystemMinneapolisMinnesotaUSA
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Fellows RP, Bangen KJ, Graves LV, Delano-Wood L, Bondi MW. Pathological functional impairment: Neuropsychological correlates of the shared variance between everyday functioning and brain volumetrics. Front Aging Neurosci 2022; 14:952145. [PMID: 36620766 PMCID: PMC9816390 DOI: 10.3389/fnagi.2022.952145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Given that several non-cognitive factors can contribute to difficulties with everyday functioning, examining the extent to which cognition is associated with brain-related changes in everyday functioning is critical to accurate characterization of cognitive disorders. In this study, we examined neuropsychological correlates of the shared variance between everyday functioning and pathological indicators of cognitive aging using MRI brain volumetrics. Participants and methods Participants were 600 adults aged 55 and older without dementia [432 cognitively normal; 168 mild cognitive impairment (MCI)] from the National Alzheimer's Coordinating Center cohort who underwent neuropsychological testing, informant-rated everyday functioning, and brain MRI scanning at baseline. The shared variance between everyday functioning and brain volumetrics (i.e., hippocampal volume, white matter hyperintensity volume) was extracted using the predicted value from multiple regression. The shared variance was used as an indicator of pathological everyday functional impairment. The residual variance from the regression analysis was used to examine functional reserve. Results Larger white matter hyperintensity volumes (p = 0.002) and smaller hippocampal volumes (p < 0.001) were significantly correlated with worse informant-rated everyday functioning. Among individuals with MCI, worse performances on delayed recall (p = 0.013) and category fluency (p = 0.012) were significantly correlated with pathological functional impairment in multiple regression analysis. In the cognitively normal group, only worse auditory working memory (i.e., digit span backward; p = 0.025) significantly correlated with pathological functioning. Functional reserve was inversely related to anxiety (p < 0.001) in the MCI group and was associated with depressive symptoms (p = 0.003) and apathy (p < 0.001) in the cognitively normal group. Conclusion Subtle brain-related everyday functioning difficulties are evident in MCI and track with expected preclinical Alzheimer's disease cognitive phenotypes in this largely amnestic sample. Our findings indicate that functional changes occur early in the disease process and that interventions to target neuropsychiatric symptoms may help to bolster functional reserve in those at risk.
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Affiliation(s)
- Robert P. Fellows
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,*Correspondence: Robert P. Fellows, ✉
| | - Katherine J. Bangen
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Lisa V. Graves
- Department of Psychology, California State University, San Marcos, CA, United States
| | - Lisa Delano-Wood
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Mark W. Bondi
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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Juras L, Martincević M, Vranić A, Rebernjak B, Hromatko I. The brief case for everyday problems: a proposal of two brief alternate forms of the Everyday Problems Test. Eur J Ageing 2022; 19:1519-1528. [PMID: 36692781 PMCID: PMC9729654 DOI: 10.1007/s10433-022-00734-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 01/26/2023] Open
Abstract
Everyday Problems Test (EPT; Willis and Marsiske, Manual for the everyday problems test, Pennsylvania State University, Pennsylvania, 1993) is an 84-item performance-based measure of older adults' everyday cognitive competencies in seven everyday domains (e.g., finance, reading prescription). Its length makes it disadvantageous in the typical time-constrained testing context. Due to the potential practice effects, it is also impractical for longitudinal and intervention studies which require repetitive testing. We have addressed these issues by adapting two brief forms of EPT, with 14 items each. The psychometric evaluation of these two versions was conducted on a sample of 157 cognitively healthy older adults. Both brief forms demonstrated good internal consistency, high inter-correlation, and have shown satisfactory concurrent criterion-related validity based on their correlations with socio-demographic and cognitive variables. Results indicate that the two proposed brief forms can be a valuable tool in assessing the everyday cognitive competence of healthy older adults either as a one-time screening instrument or as a pretest-posttest difference indicator of the intervention efficacy.
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Affiliation(s)
- Luka Juras
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Marina Martincević
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Andrea Vranić
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Blaž Rebernjak
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Ivana Hromatko
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
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Bruderer-Hofstetter M, Gorus E, Cornelis E, Meichtry A, De Vriendt P. Influencing factors on instrumental activities of daily living functioning in people with mild cognitive disorder - a secondary investigation of cross-sectional data. BMC Geriatr 2022; 22:791. [PMID: 36217106 PMCID: PMC9552428 DOI: 10.1186/s12877-022-03476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors. METHODS We performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer's Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model. RESULTS We included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern. CONCLUSION Our results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
| | - Ellen Gorus
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Elise Cornelis
- Department of Occupational Therapy and Research & Development in Health & Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - Patricia De Vriendt
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Mental Health and Wellbeing (MENT) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Programme, Ghent University, Ghent, Belgium
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Benge JF, Artz J, Kiselica A. The ecological validity of the Uniform Data Set 3.0 neuropsychological battery in individuals with mild cognitive impairment and dementia. Clin Neuropsychol 2022; 36:1453-1470. [PMID: 33103615 PMCID: PMC8071839 DOI: 10.1080/13854046.2020.1837246] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Ecological validity refers to the ability of neuropsychological measures to predict real world performance. Questions remain as to the ecological validity of commonly used measures, particularly regarding their relationships to global versus specific activities of daily living among those with neurodegenerative disease. We explored these issues through the lens of the Uniform Data Set 3.0 Neuropsychological battery (UDS3NB) in individuals with mild cognitive impairment and dementia. Method: UDS3NB and informant rated Functional Activities Questionnaire scales were evaluated from 2,253 individuals with mild cognitive impairment and dementia. Ordinal regression equations were used to explore the relationships of demographic and cognitive variables with overall and specific instrumental activities of daily living. Results: Delayed recall for visual and verbal material, and performance on trail making tests were consistent predictors of global and specific functions. Specific skills (i.e. naming or figure copy) showed differential relationships with specific activities, while phonemic fluency was not related to any particular activity. Conclusions: Measures in the UDS3NB predicted activities of daily living in individuals with MCI and dementia, providing initial support for the ecological validity of these tests. Specifically, measures that tap core deficits of Alzheimer's disease, such as delayed recall and sequencing/shifting, are consistent predictors of performance in daily tasks.
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Affiliation(s)
- Jared F. Benge
- Department of Neurology, Baylor Scott and White Health, Temple, TX
- Plummer Movement Disorder Center, BSWH Health, Temple, TX
- Texas A&M College of Medicine, Temple, TX
| | | | - Andrew Kiselica
- Department of Health Psychology, University of Missouri, Columbia, MO
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Al-Heizan MO, Marks TS, Giles GM, Edwards DF. Further Validation of the Menu Task: Functional Cognition Screening for Older Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:286-294. [PMID: 35899792 DOI: 10.1177/15394492221110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Occupational therapists need a brief tool to identify the potential for functional cognitive deficits leading to impaired occupational performance. The objective is to establish the sensitivity and specificity, concurrent and known-group validity of the Menu Task by comparison with performance on the Weekly Calendar Planning Activity (WCPA). Using a cross-sectional design, we administered the Menu Task and the WCPA to a community-dwelling convenience sample of 287 adults aged from 55 to 93 years. The receiver operating characteristic (ROC) analysis estimated sensitivity and specificity. Concurrent and known-group construct validity was examined by comparing scores on the Menu Task with the WCPA scores. As a result, a new cutoff score of 9 was established for the Menu Task (area under the curve [AUC] = 0.80, sensitivity = 0.89, 95% confidence interval [CI] = [0.73, 0.97]; specificity = 0.58, 95% CI = [0.52, 0.64]). Both concurrent and construct validity were supported. The Menu Task demonstrates sensitivity to functional cognitive impairments in a community sample.
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Affiliation(s)
| | | | - Gordon M Giles
- Samuel Merritt University, Oakland, CA, USA.,Crestwood Behavioral Health, Inc., Sacramento, CA, USA
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Mattsson P, Cselényi Z, Andrée B, Borg J, Nag S, Halldin C, Farde L. Decreased 5-HT 1A binding in mild Alzheimer's disease - a PET study. Synapse 2022; 76:e22235. [PMID: 35587913 PMCID: PMC9285435 DOI: 10.1002/syn.22235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Decreased 5-HT1A receptor binding has been associated with Alzheimer's disease (AD) and interpreted as a consequence of neuron loss. The purpose of the present study was to compare [11 C]WAY100635 binding to the 5-HT1A receptor in hippocampus, entorhinal cortex, amygdala and pericalcarine cortex in mild AD patients and elderly controls. METHODS AD patients (n = 7) and elderly control subjects (n = 8) were examined with positron emission tomography (PET) and [11 C]WAY100635. PET data acquisition was performed with an ECAT EXACT HR system. Wavelet-aided parametric images of non-displaceable binding potential (BPND ) were generated using Logan's graphical analysis with cerebellum as reference region. Correction for partial volume effects (PVE) was performed with the Müller-Gärtner method (MG). Regions of interest (ROIs) were applied to the individual parametric images and the regional BPND was calculated as the average parametric voxel value within each ROI. Besides comparison between subject groups, correlations between BPND values and scores on Mini Mental State Examination (MMSE), Disability Assessment for Dementia (DAD), and Neuropsychiatric Inventory (NPI) were expressed by Pearson correlation coefficients. RESULTS Mean regional BPND was lower in AD patients compared to control subjects and the difference was statistically significant for hippocampus, entorhinal cortex and amygdala. A statistically significant correlation was obtained between hippocampal BPND values and DAD scores. CONCLUSION The results of the present study corroborate and extend previous findings of decreased 5-HT1A binding in AD and strengthen the support for 5-HT1A receptor PET as a tool for assessment of neurodegenerative changes in mild AD. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Patrik Mattsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
| | - Zsolt Cselényi
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden.,PET Science Centre, Personalized Medicine, R&D, AstraZeneca, Stockholm, Sweden
| | - Bengt Andrée
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
| | - Jacqueline Borg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
| | - Sangram Nag
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
| | - Christer Halldin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
| | - Lars Farde
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County, Stockholm, Sweden
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11
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Van Patten R, Mahmood Z, Nguyen TT, Maye J, Kim HC, Jeste DV, Twamley EW. Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community. J Int Neuropsychol Soc 2022; 28:62-73. [PMID: 33749570 PMCID: PMC8455703 DOI: 10.1017/s1355617721000163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics. METHOD Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. RESULTS Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. CONCLUSIONS Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.
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Affiliation(s)
- Ryan Van Patten
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Zanjbeel Mahmood
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
| | - Tanya T. Nguyen
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Jacqueline Maye
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research – Almaden, San Jose, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
| | - Elizabeth W. Twamley
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
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12
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González DA, Gonzales MM, Jennette KJ, Soble JR, Fongang B. Cognitive screening with functional assessment improves diagnostic accuracy and attenuates bias. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12250. [PMID: 34934799 PMCID: PMC8652409 DOI: 10.1002/dad2.12250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Cognitive screening measures often lack sensitivity and are hampered by inequities across ethnoracial groups. A multitrait multimethod (MTMM) classification may attenuate these shortcomings. METHODS A sample of 7227 participants across the diagnostic spectrum were selected from the National Alzheimer's Coordinating Center cohort. Random forest ensemble methods were used to predict diagnosis across the sample and within Black American (n = 1025) and non-Hispanic White groups (n = 5263) based on: (1) a demographically corrected Montreal Cognitive Assessment (MoCA), (2) MoCA and Functional Assessment Questionnaire (FAQ), (3) MoCA and FAQ with demographic correction. RESULTS The MTMM approach with demographic correction had the highest diagnostic accuracy for the cognitively unimpaired (area under curve [AUC] [95% confidence interval (CI)]): 0.906 [0.892, 0.920]) and mild cognitive impairment (AUC: 0.835 [0.810, 0.860]) groups and reduced racial disparities. DISCUSSION With further validation, the MTMM approach combining cognitive screening and functional status assessment may serve to improve diagnostic accuracy and extend opportunities for early intervention with greater equity.
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Affiliation(s)
- David Andrés González
- Department of NeurologyUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Mitzi M. Gonzales
- Department of NeurologyUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Kyle J. Jennette
- Department of PsychiatryUniversity of Illinois College of MedicineChicagoIllinoisUSA
| | - Jason R. Soble
- Department of PsychiatryUniversity of Illinois College of MedicineChicagoIllinoisUSA
- Department of NeurologyUniversity of Illinois College of MedicineChicagoIllinoisUSA
| | - Bernard Fongang
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
- Department of Biochemistry and Structural BiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
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13
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Abstract
Introduction: Successful aging lies in cognitive and functional maintenance, and in the optimal performance of daily tasks that keep the elderly free of disability and dependence. However, there is little evidence for functional differences for gender and age, and how cognitive and physical demands in past working lives can affect them, to design more personalized occupational therapy interventions to prevent functional and cognitive impairment. Method: This observational descriptive study evaluated 367 older adults living in a community with subjective memory complaints and scored between 24 and 35 with the Spanish version of the “Mini-Mental State Examination (MEC-35)”. Basic activities of daily living (BADL) were studied with the Barthel Index, while instrumental ADL (IADL) were examined with the Lawton–Brody scale. Functional differences for gender, age, and physico-mental occupation were examined. Results: The significant differences found for gender indicated that men did better in BADL (p = 0.026) and women better performed IADL (p < 0.001). Differences between age groups suggest that the younger group (aged 64–75) obtained better results for BADL (p = 0.001) and IADL (p < 0.001). For physico-mental occupation, statistically significant differences were found only in IADL for mental (p = 0.034) and physical occupation (p = 0.005). Conclusions: Gender, age, and the cognitive and physical demands of occupational stages, can be important predictors of cognitive and functional impairment. These results can be generalized to other health centers in the province and to other Spanish Autonomous Communities because their socio-demographic variables are similar. It would be interesting to carry out multimodal personalized interventions that consider the factors that might affect functional impairment to preserve personal autonomy.
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14
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Schmitter-Edgecombe M, Cunningham R, McAlister C, Arrotta K, Weakley A. The night out task and scoring application: an ill-structured, open-ended clinic-based test representing cognitive capacities used in everyday situations. Arch Clin Neuropsychol 2021; 36:537-553. [PMID: 33089318 DOI: 10.1093/arclin/acaa080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/07/2020] [Accepted: 09/07/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The night out task (NOT) was developed as a naturalistic, open-ended, multitasking measure that requires individuals to complete eight subtasks comparable to those encountered during real-world functioning (e.g., pack travel bag, prepare tea). We examined psychometric properties and administration feasibility of this direct observation measure within a clinic-like setting using a tablet-based coding application. METHOD A sample of 148 community-dwelling older adults (82% cognitively healthy; 18% mild cognitive impairment) and 57 younger adults completed the NOT along with other neurocognitive tests and questionnaires. RESULTS Inter-rater reliability across NOT primary (i.e., time, accuracy, efficiency) and process-related (e.g., error-types, self-corrections) variables was mostly excellent. NOT primary measures showed expected patterns of convergent and discriminant validity with measures of cognition, demographics, and well-being. External validity was established by the NOT ability to distinguish between age and diagnostic (cognitively healthy vs. mild cognitive impairment) groups. Demonstrating incremental validity, the NOT primary variables (execution time in particular) were predictive of self-reported functional abilities and completion quality of in-home everyday tasks over and earlier variables such as demographics, cognition, and mobility. CONCLUSIONS These findings suggest that the NOT and its app interface, which allows for continuous logging of observations, are a feasible in-clinic measure to assess cognitive capacities important for real-world functioning. With further validation, the NOT may allow for earlier detection of functional difficulties. Understanding errors and strategies used during NOT performance could also have implications for individualized interventions.
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Affiliation(s)
| | - Reanne Cunningham
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Courtney McAlister
- Mayo Clinic School of Medicine, Mayo Clinic Health System, La Crosse, WI, USA
| | - Kayela Arrotta
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Alyssa Weakley
- Neurology Department, School of Medicine, University of California, Davis, Sacramento, CA, USA
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15
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Giovannetti T, Mis R, Hackett K, Simone SM, Ungrady MB. The goal-control model: An integrated neuropsychological framework to explain impaired performance of everyday activities. Neuropsychology 2021; 35:3-18. [PMID: 33393796 DOI: 10.1037/neu0000714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This review describes the relatively small body of neuropsychological and cognitive research conducted over the past 100 years focused on theoretical models explaining the neurocognitive processes that support everyday functioning and the breakdown of functional abilities in the face of neurological damage or disease. METHOD The historical roots of the theories of everyday activities based on direct observation of behavior in neurology and diary reports of everyday errors in cognitive psychology are presented, followed by a review of the empirical findings and resulting theoretical conceptualizations from case studies and group studies of various clinical populations in neuropsychology. RESULTS We conclude with a new framework (the goal-control model) that integrates the most recent empirical findings in neuropsychology with mechanisms proposed by cognitive models. CONCLUSIONS The goal-control model offers empirically supported solutions to understanding and predicting functioning in the real world. This new model generates testable predictions for future research and provides guidance for clinical assessment and interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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16
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Curtis A, Gooden JR, Cox CA, Harries T, Peterson V, Enticott PG, Sanfilippo PG, Miller PG, Lubman DI, Manning V. Neurocognitive functioning among people accessing an addiction neuropsychology clinic with and without a history of offending behaviour. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 28:854-866. [PMID: 35694648 PMCID: PMC9176380 DOI: 10.1080/13218719.2021.1873204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Effectiveness of interventions for violent behaviour may be undermined by the presence of neurocognitive impairment, which is known to be common among alcohol and other drug (AOD) users and violent offenders. The current study aimed to examine whether the cognitive functioning of individuals with AOD histories presenting to a specialist addiction neuropsychology service differed according to their offending history (i.e. non-offending, non-violent offending and violent offending), using a retrospective case file audit design. Data were extracted from 190 clients. Tests assessed a breadth of cognitive domains. Violent offenders demonstrated the lowest premorbid IQ out of the three groups, and a significantly higher proportion of violent offenders presented with impaired divided attention and impaired cognitive inhibition compared to non-violent offenders. Rates of impairment across groups were well beyond those expected within the general population. Delivery of both AOD and violence interventions should be adapted to accommodate individuals' cognitive difficulties.
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Affiliation(s)
- Ashlee Curtis
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - James R. Gooden
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Box Hill, VIC, Australia
| | | | - Travis Harries
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | | | - Paul G. Sanfilippo
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Peter G. Miller
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Dan I. Lubman
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
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17
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Passler JS, Kennedy RE, Crowe M, Clay OJ, Howard VJ, Cushman M, Unverzagt FW, Wadley VG. The relationship of cognitive change over time to the self-reported Ascertain Dementia 8-item Questionnaire in a general population. Arch Clin Neuropsychol 2021; 36:243-252. [PMID: 32613226 DOI: 10.1093/arclin/acz045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/11/2019] [Accepted: 08/14/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of the study was to examine the relationship between longitudinally assessed cognitive functioning and self-reported dementia status using the Ascertain Dementia 8-item questionnaire (AD8) in a national population-based sample. METHODS The analysis included 14,453 participants from the REasons for Geographic and Racial Differences in Stroke study. A validated cutoff of ≥2 symptoms endorsed on the AD8 (administered 10 years after enrollment) represented positive AD8 status. Incident cognitive impairment was defined as change from intact to impaired status in the Six-Item Screener score, and cognitive decline was defined by trajectories of Letter "F" Fluency from the Montreal Cognitive Assessment, and Animal Fluency, Word List Learning, and Word List Delayed recall, all from the Consortium to Establish a Registry for Alzheimer's Disease battery. Logistic regression models controlled for demographics, health variables, and depressive symptoms. RESULTS Sensitivity and specificity of the AD8 to detect incident cognitive impairment were 45.2% and 78.4%, respectively. Incident cognitive impairment and a one-word decline in WLL increased the odds of self-reported positive AD8 by 96% (95% CI: 1.68-2.28) and 27% (95% CI: 1.17-1.37), respectively. There was a strong association between high depression risk and self-reported positive AD8 in sensitivity analyses. CONCLUSIONS Incident cognitive impairment and high depression risk were the strongest predictors of self-reported positive AD8 in this population-based sample. Our results inform the utility of the AD8 as a self-report measure in a large, national sample that avoids selection biases inherent in clinic-based studies. The AD8 is screening measure and should not be used to diagnose dementia clinically.
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Affiliation(s)
- Jesse S Passler
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard E Kennedy
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | | | - Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Pavlidis G, Hatzifilalithis S, Marwan Zawaher N, Papaioannou G, Giagkousiklidou E, Vivas AB. The Cultural Adaptation of the Everyday Problems Test-Greek Version: An Instrument to Examine Everyday Functioning. Gerontol Geriatr Med 2021; 7:23337214211027683. [PMID: 34286049 PMCID: PMC8261850 DOI: 10.1177/23337214211027683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/28/2021] [Accepted: 06/06/2021] [Indexed: 11/28/2022] Open
Abstract
Assessing cognitive decline and everyday functioning (EvF) in older age is valuable in detecting age-related neurological disorders. In Greece, there is a lack of sensitive instruments that capture fluctuations in EvF among older persons who are cognitively healthy or have subtle cognitive impairments. The EPT 28-items test, a widely used paper-and-pencil EvF measure, was translated in Greek and adapted to the Greek culture in this study. A multi-step methodology using a sample of 139 older Greek persons was employed. The results indicate that the Greek version of the EPT 28-items (i.e., the EPT-G) was well adapted, representing everyday tasks in Greece within a good range of task difficulty. The psychometric properties of the EPT-G replicate those of the original instrument, capturing EvF fluctuations among older persons with mild cognitive impairments. It was concluded that the EPT-G is a useful measure of EvF among Greek older persons.
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Affiliation(s)
| | | | | | | | | | - Ana B. Vivas
- The University of Sheffield,
International Faculty, Thessaloniki, Greece
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19
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Bruderer-Hofstetter M, Sikkes SAM, Münzer T, Niedermann K. Development of a model on factors affecting instrumental activities of daily living in people with mild cognitive impairment - a Delphi study. BMC Neurol 2020; 20:264. [PMID: 32611388 PMCID: PMC7329426 DOI: 10.1186/s12883-020-01843-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction The level of function of instrumental activities of daily living (IADL) is crucial for a person’s autonomy. A clear understanding of the nature of IADL and its limitations in people with mild cognitive impairment (MCI) is lacking. Literature suggests numerous possible influencing factors, e.g. cognitive function, but has not considered other domains of human functioning, such as environmental factors. Our aim was to develop a comprehensive model of IADL functioning that depicts the relevant influencing factors. Methods We conducted a four-round online Delphi study with a sample of international IADL experts (N = 69). In the first round, panelists were asked to mention all possible relevant cognitive and physical function factors, as well as environmental and personal factors, that influence IADL functioning. In the subsequent rounds, panelists rated the relevance of these factors. Consensus was defined as: 1) ≥70% agreement between panelists on a factor, and 2) stability over two successive rounds. Results Response rates from the four rounds were high (83 to 100%). In the first round, 229 influencing factors were mentioned, whereof 13 factors reached consensus in the subsequent rounds. These consensual factors were used to build a model of IADL functioning. The final model included: five cognitive function factors (i.e. memory, attention, executive function, and two executive function subdomains -problem solving / reasoning and organization / planning); five physical function factors (i.e. seeing functions, hearing functions, balance, gait / mobility functions and functional mobility functions); two environmental factors (i.e. social network / environment and support of social network / environment); and one personal factor (i.e. education). Conclusions This study proposes a comprehensive model of IADL functioning in people with MCI. The results from this Delphi study suggest that IADL functioning is not merely affected by cognitive function factors, but also by physical function factors, environmental factors and personal factors. The multiplicity of factors mentioned in the first round also underlines the individuality of IADL functioning in people with MCI. This model may serve as a basis for future research in IADL functioning in people with MCI.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Helath Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Centers / Department of Clinical, Neuro and Developmental Psychology, VU University / Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Thomas Münzer
- Geriatrische Klinik St.Gallen, St.Gallen, Switzerland.,Department of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
| | - Karin Niedermann
- School of Helath Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
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20
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Hackett K, Mis R, Drabick DAG, Giovannetti T. Informant Reporting in Mild Cognitive Impairment: Sources of Discrepancy on the Functional Activities Questionnaire. J Int Neuropsychol Soc 2020; 26:503-514. [PMID: 31964443 PMCID: PMC7205566 DOI: 10.1017/s1355617719001449] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Relative to dementia, little is known about informant bias in mild cognitive impairment (MCI). We investigated the influence of informant demographic and relational characteristics on reports of everyday functioning using the Functional Activities Questionnaire (FAQ). METHOD Four thousand two hundred eighty-four MCI participants and their informants from the National Alzheimer's Coordinating Center Uniform Data Set were included. Informants were stratified according to cohabitation, relationship, visit frequency, race/ethnicity, education, and sex. Informant-rated Mean FAQ score was compared across these groups using univariate general linear model analyses and post hoc tests. Interactions were tested between informant variables. The predictive contribution of informant variables to FAQ score was explored using hierarchical linear regression. Analyses covaried for participant cognition using a cognitive composite score, and for participant age, sex, and depression. RESULTS After controlling for participant cognition, depression, age, and sex, informant-rated FAQ scores varied significantly across all informant variables (p's < .005, ηp2's ≤ .033) except sex and visit frequency. FAQ scores were higher (more impaired) among informants who cohabitate with the participant, among paid caregivers, spouses, and adult children, and among informants with higher levels of education. Scores were lowest (less impaired) among Black/African American informants as compared to all other racial/ethnic groups. CONCLUSIONS Demographic and relational characteristics of informants influence the perception and reporting of instrumental activities of daily living in adults with MCI. As everyday functioning is crucial for differential diagnosis and treatment outcome measurement, it is important to be aware of sources of informant report discrepancies.
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Affiliation(s)
| | - Rachel Mis
- Temple University, Department of Psychology
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21
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Schmitter-Edgecombe M, Sumida C, Cook DJ. Bridging the gap between performance-based assessment and self-reported everyday functioning: An ecological momentary assessment approach. Clin Neuropsychol 2020; 34:678-699. [PMID: 32189568 PMCID: PMC7225027 DOI: 10.1080/13854046.2020.1733097] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/01/2020] [Accepted: 02/16/2020] [Indexed: 10/24/2022]
Abstract
Objective: In the real-world environment, multiple and interacting state-dependent factors (e.g., fatigue, distractions) can cause cognitive failures and negatively impact everyday activities. This study used ecological momentary assessment (EMA) and a n-back task to examine the relationship between fluctuating levels of cognition measured in the real-world environment and self-report and performance-based measures of functional status.Method: Thirty-five community-dwelling older adults (M age = 71.80) completed a brief battery of objective and self-report measures of cognitive and functional status. After completing 100, 45-second trials to reach stable performance on a n-back task, EMA data collection began. Four times daily for one week, participants received prompts on a tablet to complete a n-back task and a brief survey. From the EMA n-back trials, measures of EMA average performance and intra-individual variability (IIV) across performances were created.Results: For the EMA n-back, the correlation between IIV and EMA average was weak and non-significant. IIV associated with self-report measures, and EMA average with the objective, performance-based functional status composite. Hierarchical regressions further revealed that IIV was a significant predictor of self-reported functional status and cognitive failures over and above EMA average performance and global cognitive status. In contrast, for the objective, functional status composite, IIV did not explain additional variance.Conclusions: The findings suggest that IIV and self-report measures of functional status and cognitive failures may capture a real-world cognitive capacity that fluctuates over time and with context; one that may not easily be captured by objective, performance-based measures designed to assess optimal function.
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Affiliation(s)
| | - Catherine Sumida
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Diane J Cook
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, USA
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22
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Lane NE, Stukel TA, Boyd CM, Wodchis WP. Long-Term Care Residents' Geriatric Syndromes at Admission and Disablement Over Time: An Observational Cohort Study. J Gerontol A Biol Sci Med Sci 2020; 74:917-923. [PMID: 29955879 PMCID: PMC6521919 DOI: 10.1093/gerona/gly151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Indexed: 01/29/2023] Open
Abstract
Background Disablement occurs when people lose their ability to perform activities of daily living (ADLs) like bathing and dressing, and is measured as the rate of increasing disability over time. We examined whether balance impairment, cognitive impairment, or pain among residents at admission to long-term care homes were predictive of their rate of disablement over the subsequent 2 years. Methods Linked administrative databases were used to conduct a longitudinal cohort study of 12,334 residents admitted to 633 long-term care (LTC) homes between April 1, 2011 and March 31, 2012, in Ontario, Canada. Residents received an admission assessment of disability upon admission to LTC using the RAI-MDS 2.0 ADL long-form score (ADL LFS, range 0–28) and at least two subsequent disability assessments. Multivariable regression models estimated the adjusted association between balance impairment, cognitive impairment, and pain present at admission and residents’ subsequent disablement over 2 years. Results This population sample of newly admitted Ontario long-term care residents had a median disability score of 13 (interquartile range [IQR] = 7, 19) at admission. Greater balance impairment and cognitive impairment at admission were significantly associated with faster resident disablement over 2 years in adjusted models, while daily pain was not. Conclusions Balance impairment and cognitive impairment among newly admitted long-term care home residents are associated with increased rate of disablement over the following 2 years. Further research should examine the mechanisms driving this association and identify whether they are amenable to intervention.
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Affiliation(s)
- Natasha E Lane
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Thérèse A Stukel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Cynthia M Boyd
- Johns Hopkins School of Medicine, Baltimore, Maryland.,Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Johns Hopkins Center on Aging and Health, Baltimore, Maryland
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute for Better Health, Trillium Health Partners, Mississauga, Ontario
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23
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Contador I, Fernández-Calvo B, Rueda-Revé L, Olazarán J, Bermejo-Pareja F. Characterizing functional alterations in instrumental activities of daily living using latent class analysis: a population-based study (NEDICES). Aging Ment Health 2020; 24:41-48. [PMID: 30450947 DOI: 10.1080/13607863.2018.1512082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background and Objectives: The existence of different patterns of functional impairment in older adults has scarcely been addressed. This research investigates major patterns of functional impairment based on Pfeffer's Functional Activity Questionnaire (FAQ).Research Design and Methods: The participants come from NEDICES (Neurological Disorders in Central Spain), a prospective population-based cohort study. A total of 3837 individuals without dementia who completed the Spanish version of the FAQ was selected. Latent Class Analysis (LCA) was carried out to examine potential cluster subgroups based on FAQ responses.Results: The FAQ showed good internal consistency (Cronbach's alpha: 0.86) and moderate correlation (r = -.40) with cognitive performance on the Mini-Mental State Examination (MMSE-37). The response patterns revealed the presence of three latent classes: absence of functional alteration (Class 1), established functional alteration (Class 2), and minimal functional alteration (Class 3). Moreover, the probability of resolving Items 2 ('shopping alone for…'), 3 ('heating water…'), 4 ('preparing a balanced meal'), and 9 ('travelling out of neighbourhood…') was close to 0% for Class 2 membership, while those with the lowest probability of resolution for Class 3 were Items 2 and 9. Items 3 and 4 were the best to discriminate between different grades of functional alterations (Class 2 vs. Class 3).Discussion and Implications: Our findings indicate that the combination of overall FAQ score and item response pattern may help to classify individuals with different subtypes of functional impairment. The Spanish version of the FAQ is a useful tool for detection of functional impairment in older adults.
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Affiliation(s)
- Israel Contador
- Faculty of Psychology,Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Spain
| | | | - Laura Rueda-Revé
- Faculty of Psychology,Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Spain
| | - Javier Olazarán
- Department of Neurology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Félix Bermejo-Pareja
- Research Institute of Hospital '12 de Octubre' (i + 12), Madrid, Spain.,The Biomedical Research Centre Network for Neurodegenerative Diseases (CIBERNED), Carlos III Research Institute, Madrid, Spain.,Faculty of Medicine, Complutense University, Madrid, Spain
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Ord AS, Phillips JI, Wolterstorff T, Kintzing R, Slogar SM, Sautter SW. Can deficits in functional capacity and practical judgment indicate cognitive impairment in older adults? APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:737-744. [PMID: 31835920 DOI: 10.1080/23279095.2019.1698582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Neuropsychological literature has demonstrated a significant relationship between cognitive decline and functional capacity, but the directionality of this relationship is still not well understood. Further, the construct of practical judgment has been linked to both cognitive impairment and functional capacity, but these associations are still under-researched. Moreover, few studies to date have examined the relationships among all three constructs utilizing performance-based, ecologically valid and psychometrically sound measures. The present study aimed to address this gap in published literature and investigated whether a practical judgment and functional capacity can help differentiate individuals with cognitive dysfunction from those without. Participants were 270 community-dwelling individuals aged 56-95 years referred for neuropsychological evaluation in an outpatient setting. Bivariate correlations revealed moderate to strong relationships among the three studied variables. Additionally, logistic regression analysis indicated that ability to make sound practical judgments and ability to perform instrumental activities of daily living (IADL) can be used as indicators of cognitive impairment. The clinical implications of these findings are discussed.
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Affiliation(s)
- Anna S Ord
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA.,W. G. Hefner VA Medical Center, Salisbury, NC, USA.,Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA
| | - Jacob I Phillips
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA
| | - Trevor Wolterstorff
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA
| | - Rebekah Kintzing
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA
| | - Sue-Mei Slogar
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- School of Psychology and Counseling, Regent University, Virginia Beach, VA, USA
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Bangen KJ, Thomas KR, Weigand AJ, Sanchez DL, Delano-Wood L, Edmonds EC, Carmichael OT, Schwarz CG, Brickman AM, Bondi MW. Pattern of regional white matter hyperintensity volume in mild cognitive impairment subtypes and associations with decline in daily functioning. Neurobiol Aging 2019; 86:134-142. [PMID: 31791658 DOI: 10.1016/j.neurobiolaging.2019.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/04/2019] [Accepted: 10/26/2019] [Indexed: 01/18/2023]
Abstract
White matter hyperintensities (WMHs), a marker of small-vessel cerebrovascular disease, increase risk for mild cognitive impairment (MCI). Less is known about whether regional WMHs distinguish MCI subtypes and predict decline in everyday functioning. About 618 Alzheimer's Disease Neuroimaging Initiative participants (301 cognitively normal [CN]; 232 amnestic MCI [aMCI]; 85 nonamnestic MCI [naMCI]) underwent neuropsychological testing, MRI, and assessment of everyday functioning. aMCI participants showed greater temporal (p = 0.002) and occipital WMHs (p = 0.030) relative to CN whereas naMCI participants had greater frontal (p = 0.045), temporal (p = 0.003), parietal (p = 0.018), and occipital (p < 0.001) WMH compared with CN. Relative to those with aMCI, individuals with naMCI showed greater occipital WMH (p = 0.013). Greater WMH in temporal (p = 0.001) and occipital regions (p = 0.006) was associated with faster decline in everyday functioning across the sample. Temporal lobe WMHs were disproportionately associated with accelerated functional decline among naMCI (p = 0.045). Regional WMH volumes vary across cognitive groups and predict functional decline. Cerebrovascular markers may help identify individuals at risk for decline and distinguish subtypes of cognitive impairment.
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Affiliation(s)
- Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| | - Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Alexandra J Weigand
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Danielle L Sanchez
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, CA, USA; Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Emily C Edmonds
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | | | | | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, CA, USA; Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
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Lamash L, Josman N. A metacognitive intervention model to promote independence among individuals with autism spectrum disorder: Implementation on a shopping task in the community. Neuropsychol Rehabil 2019; 31:189-210. [PMID: 31665973 DOI: 10.1080/09602011.2019.1682621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Adolescents with autism spectrum disorder show low independence levels and difficulty performing complex daily activities. The many intervention approaches for these individuals include deconstructing complex activities into basic components, processing and practicing tasks, and developing compensation strategies. The aim of this study was to examine the effectiveness of a short-term metacognitive intervention combined with virtual supermarket practice to improve the independent implementation of a shopping task among adolescents with autism spectrum disorder. The study included 56 adolescents with autism spectrum disorder, of whom 33 performed the metacognitive intervention and 23 served as controls. Outcome measures included assessments of cognitive and metacognitive functions and a performance-based evaluation of a shopping task in the natural environment. Compared to the control group, the intervention group experienced significant improvement in accuracy and efficiency while performing a shopping task. In addition, the executive functions domain was found to be the main predictor of accuracy and efficiency in performing the shopping task. These findings indicate the short-term metacognitive intervention, reinforced by a technology-based training programme, may effectively enhance the independent execution of a shopping task by adolescents with autism spectrum disorder and expand their potential participation in the community.
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Affiliation(s)
- Liron Lamash
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Naomi Josman
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
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Brunette AM, Calamia M, Black J, Tranel D. Is Episodic Future Thinking Important for Instrumental Activities of Daily Living? A Study in Neurological Patients and Healthy Older Adults. Arch Clin Neuropsychol 2019; 34:403-417. [PMID: 29893785 PMCID: PMC6454851 DOI: 10.1093/arclin/acy049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 05/10/2018] [Accepted: 05/16/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Episodic future thinking is the ability to mentally project oneself into the future. This construct has been explored extensively in cognitive neuroscience and may be relevant for adaptive functioning. However, it has not been determined whether the measurement of episodic future thinking might be valuable in a clinical neuropsychological setting. The current study investigated (1) the relationship between episodic future thinking and instrumental activities of daily living (IADLs); and (2) whether episodic future thinking is related to IADLs over and above standard measures of cognition. METHOD Sixty-one older adults with heterogeneous neurological conditions and 41 healthy older adults completed a future thinking task (the adapted Autobiographical Interview), a performance-based measure of instrumental activities of daily living (the Independent Living Scales), and standard clinical measures of memory and executive functioning. RESULTS Episodic future thinking significantly predicted IADLs after accounting for age, education, gender, and depression (increase in R2 = .050, p = .010). Episodic future thinking significantly predicted IADLs over and above executive functioning (increase in R2 = .025, p = .030), but was not predictive of IADLs over and above memory (p = .157). CONCLUSIONS This study suggests that episodic future thinking is significantly associated with IADLs, beyond what can be accounted for by executive functioning. However, episodic future thinking did not predict IADLs over and above memory. Overall, there is limited evidence for the clinical utility of episodic future thinking. The findings suggest that an episodic future thinking task does not provide enough valuable information about IADLs to justify its inclusion in a clinical neuropsychological setting.
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Affiliation(s)
- Amanda M Brunette
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Jenah Black
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Daniel Tranel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Emmert NA, Schwarz LR, Vander Wal JS, Gfeller JD. Neuropsychological predictors of health and safety abilities in dementia. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:94-106. [PMID: 31039631 DOI: 10.1080/23279095.2019.1599893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Independent Living Scales Health and Safety (ILS HS) scale is commonly used by neuropsychologists when evaluating older adults' instrumental activities of daily living (IADLs). However, there is a minimal amount of research on its use in dementia populations and, specifically, its relationship to other neuropsychological measures. The present study investigated relationships between the ILS HS scale and measures of cognition and depression. The study utilized archival data from a sample (N = 142) of older adults (mean age = 77.85) diagnosed with dementia, who were evaluated at Saint Louis University Medical Center and administered the ILS HS scale as part of a larger clinical neuropsychological evaluation. Multiple regression analyses demonstrated that up to 37% of the variance in ILS HS performance was accounted for by demographic variables, premorbid intelligence, and cognitive functioning (e.g., global cognition, delayed verbal recall, and executive functioning), and regression models demonstrated medium to large effect sizes. Depression and self- or informant-reported IADLs were unrelated to the ILS HS scale. Results suggest that older adults' ability to function in health and safety-related situations requires a range of cognitive abilities. Performance on these measures may help guide clinical decision making regarding independent living and treatment planning.
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Passler JS, Kennedy RE, Clay OJ, Crowe M, Howard VJ, Cushman M, Unverzagt FW, Wadley VG. The relationship of longitudinal cognitive change to self-reported IADL in a general population. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:125-139. [PMID: 30915889 DOI: 10.1080/13825585.2019.1597008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the relationship between cognitive change and instrumental activities of daily living (IADL) in a large, national, population-based sample. Cognitive change was assessed via verbal fluency, word list learning (WLL), and word list delayed recall (WLD). Incident cognitive impairment was defined by change in Six-Item Screener (SIS) status over a period of 10 years. Impaired IADL was defined as self-reported difficulty or needing assistance performing any IADL at Year 10. A one-word decrease in WLL over a 10-year span increased the odds of impaired IADL by 16% (95% CI 1.08-1.24) and incident cognitive impairment increased the odds of impaired IADL by 59% (95% CI 1.36-1.85) when adjusting for demographic factors, health-related behaviors, vascular risk factors and disease, and depressive symptoms. Cognitive change most strongly predicted impairment in managing finances (OR 2.47, 95% CI 2.04-3.00) and driving (OR 2.06, 95% CI 1.73-2.44).
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Affiliation(s)
- Jesse S Passler
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard E Kennedy
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | | | - Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Cook DJ, Schmitter-Edgecombe M, Jonsson L, Morant AV. Technology-Enabled Assessment of Functional Health. IEEE Rev Biomed Eng 2018; 12:319-332. [PMID: 29994684 DOI: 10.1109/rbme.2018.2851500] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The maturation of pervasive computing technologies has dramatically altered the face of healthcare. With the introduction of mobile devices, body area networks, and embedded computing systems, care providers can use continuous, ecologically valid information to overcome geographic and temporal barriers and thus provide more effective and timely health assessments. In this paper, we review recent technological developments that can be harnessed to replicate, enhance, or create methods for assessment of functional performance. Enabling technologies in wearable sensors, ambient sensors, mobile technologies, and virtual reality make it possible to quantify real-time functional performance and changes in cognitive health. These technologies, their uses for functional health assessment, and their challenges for adoption are presented in this paper.
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St-Hilaire A, Parent C, Potvin O, Bherer L, Gagnon JF, Joubert S, Belleville S, Wilson MA, Koski L, Rouleau I, Hudon C, Macoir J. Trail Making Tests A and B: regression-based normative data for Quebec French-speaking mid and older aged adults. Clin Neuropsychol 2018; 32:77-90. [DOI: 10.1080/13854046.2018.1470675] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alexandre St-Hilaire
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Camille Parent
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
- École de psychologie, Université Laval, Québec, Canada
| | - Olivier Potvin
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Louis Bherer
- Department de médecine, Université de Montréal, Montréal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Canada
- Centre de recherche, Institut de Cardiologie de Montréal, Montréal, Canada
| | - Jean-François Gagnon
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
- Centre d’Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Sven Joubert
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Canada
- Département de psychologie, Université de Montréal, Montréal, Canada
| | - Sylvie Belleville
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Canada
- Département de psychologie, Université de Montréal, Montréal, Canada
| | - Maximiliano A. Wilson
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
- Département de réadaptation, Université Laval, Québec, Canada
| | - Lisa Koski
- Département de neurologie, Université McGill, Montréal, Canada
- Neurorehabilitation Research Centre, Montréal, Canada
| | - Isabelle Rouleau
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
- Centre de recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Carol Hudon
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
- École de psychologie, Université Laval, Québec, Canada
| | - Joël Macoir
- Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada
- Département de réadaptation, Université Laval, Québec, Canada
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Beaver J, Schmitter-Edgecombe M. Multiple Types of Memory and Everyday Functional Assessment in Older Adults. Arch Clin Neuropsychol 2018; 32:413-426. [PMID: 28334170 DOI: 10.1093/arclin/acx016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/11/2017] [Indexed: 11/13/2022] Open
Abstract
Objective Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. Method A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. Results After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. Conclusion The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability.
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Affiliation(s)
- Jenna Beaver
- Department of Psychology, Washington State University, Pullman, WA , USA
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Urquijo MF, Zapata LF, Lewis S, Pineda-Alhucema W, Doria Falquez L, Lopera-Pérez DC. Influencia del riesgo social en la teoría de la mente y funciones ejecutivas de adolescentes colombianos. UNIVERSITAS PSYCHOLOGICA 2017. [DOI: 10.11144/javeriana.upsy16-2.irst] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
El objetivo del presente estudio fue determinar la relación que existe entre las Funciones Ejecutivas (FE) y la Teoría de la Mente (ToM) en población colombiana en condición de riesgo social. Participaron 78 adolescentes (41 en riesgo social y 37 controles) entre los 13 y 16 años. Se administraron el Test de Palabras y Colores de Stroop, el Test de la Pirámide de México y el Test de Falso Paso para evaluar Control Inhibitorio, Planificación y ToM, respectivamente. A pesar de que no se encontraron diferencias significativas en los procesos ejecutivos de control inhibitorio y planificación, los controles mostraron tener mejor desempeño en la prueba de ToM (p<0,05).
Adicionalmente, mientras que al interior del grupo sin riesgo social se observó una relación entre la ToM y los procesos ejecutivos evaluados (ps<0,05), sin embargo, al interior del grupo en riesgo social estos procesos no están relacionados. Se concluye que el entorno de riesgo social parece no afectar las habilidades ejecutivas de control inhibitorio y planificación pero sí la habilidad para realizar inferencias acerca de los estados mentales de los otros. De esta manera, un entorno de riesgo social es un factor ambiental que parece disociar el proceso de desarrollo de la cognición social y de los procesos ejecutivos en adolescentes, desarrollo que debería darse de manera paralela.
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Longitudinal Trajectories of Informant-Reported Daily Functioning in Empirically Defined Subtypes of Mild Cognitive Impairment. J Int Neuropsychol Soc 2017; 23:521-527. [PMID: 28487004 PMCID: PMC5524519 DOI: 10.1017/s1355617717000285] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Within the Alzheimer's Disease Neuroimaging Initiative (ADNI)'s mild cognitive impairment (MCI) cohort, we previously identified MCI subtypes as well as participants initially diagnosed with MCI but found to have normal neuropsychological, biomarker, and neuroimaging profiles. We investigated the functional change over time in these empirically derived MCI subgroups. METHODS ADNI MCI participants (n=654) were classified using cluster analysis as Amnestic MCI (single-domain memory impairment), Dysnomic MCI (memory+language impairments), Dysexecutive/Mixed MCI (memory+language+attention/executive impairments), or Cluster-Derived Normal (CDN). Robust normal control participants (NCs; n=284) were also examined. The Functional Activities Questionnaire (FAQ) was administered at baseline through 48-month follow-up. Multilevel modeling examined FAQ trajectories by cognitive subgroup. RESULTS The Dysexecutive/Mixed group demonstrated the fastest rate of decline across all groups. Amnestic and Dysnomic groups showed steeper rates of decline than CDNs. While CDNs had more functional difficulty than NCs across visits, both groups' mean FAQ scores remained below its suggested cutoff at all visits. CONCLUSIONS Results (a) show the importance of executive dysfunction in the context of other impaired cognitive domains when predicting functional decline in at-risk elders, and (b) support our previous work demonstrating that ADNI's MCI criteria may have resulted in false-positive MCI diagnoses, given the CDN's better FAQ trajectory than those of the cognitively impaired MCI groups. (JINS, 2017, 23, 521-527).
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Beaver J, Wilson KB, Schmitter-Edgecombe M. Characterising omission errors in everyday task completion and cognitive correlates in individuals with mild cognitive impairment and dementia. Neuropsychol Rehabil 2017; 29:804-820. [PMID: 28617099 DOI: 10.1080/09602011.2017.1337039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Functional ability declines with age and cognitive impairment. This study investigated errors of omission made by community-dwelling older adults completing everyday tasks in a naturalistic setting. METHOD Sixty-five cognitively healthy older adults (HOA), 19 individuals with single domain mild cognitive impairment (sdMCI), 33 individuals with multi-domain MCI (mdMCI), and 13 individuals with dementia completed measures of memory, processing speed, working memory, and executive functioning, as well as eight different activities of daily living in a naturalistic environment. Task steps were divided into preparatory, action-oriented, and concluding steps. RESULTS For action-oriented steps, the number of omission errors increased with level of cognitive impairment beyond sdMCI (i.e., HOA = sdMCI < mdMCI < dementia). In contrast, for preparatory and concluding steps, the dementia group committed more omission errors than the HOA, sdMCI, and mdMCI groups, which did not differ. CONCLUSIONS The results suggest that the more complex and integrative action-oriented steps may be the first type of everyday task step to be affected in the process of cognitive decline, with preparatory and concluding steps being preserved longer and only showing decline in later stages of impairment (i.e., dementia). Individuals with sdMCI may use other intact abilities to compensate for task omission errors.
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Affiliation(s)
- Jenna Beaver
- a Department of Psychology , Washington State University , Pullman , USA
| | - Kaci B Wilson
- a Department of Psychology , Washington State University , Pullman , USA
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Rycroft SS, Giovannetti T, Divers R, Hulswit J. Sensitive performance-based assessment of everyday action in older and younger adults. AGING NEUROPSYCHOLOGY AND COGNITION 2017; 25:259-276. [DOI: 10.1080/13825585.2017.1287855] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Ross Divers
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Jacob Hulswit
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Fellows RP, Dahmen J, Cook D, Schmitter-Edgecombe M. Multicomponent analysis of a digital Trail Making Test. Clin Neuropsychol 2016; 31:154-167. [PMID: 27690752 DOI: 10.1080/13854046.2016.1238510] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The purpose of the current study was to use a newly developed digital tablet-based variant of the TMT to isolate component cognitive processes underlying TMT performance. METHOD Similar to the paper-based trail making test, this digital variant consists of two conditions, Part A and Part B. However, this digital version automatically collects additional data to create component subtest scores to isolate cognitive abilities. Specifically, in addition to the total time to completion and number of errors, the digital Trail Making Test (dTMT) records several unique components including the number of pauses, pause duration, lifts, lift duration, time inside each circle, and time between circles. Participants were community-dwelling older adults who completed a neuropsychological evaluation including measures of processing speed, inhibitory control, visual working memory/sequencing, and set-switching. The abilities underlying TMT performance were assessed through regression analyses of component scores from the dTMT with traditional neuropsychological measures. RESULTS Results revealed significant correlations between paper and digital variants of Part A (rs = .541, p < .001) and paper and digital versions of Part B (rs = .799, p < .001). Regression analyses with traditional neuropsychological measures revealed that Part A components were best predicted by speeded processing, while inhibitory control and visual/spatial sequencing were predictors of specific components of Part B. Exploratory analyses revealed that specific dTMT-B components were associated with a performance-based medication management task. CONCLUSIONS Taken together, these results elucidate specific cognitive abilities underlying TMT performance, as well as the utility of isolating digital components.
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Affiliation(s)
- Robert P Fellows
- a Department of Psychology , Washington State University , Pullman , WA , USA
| | - Jessamyn Dahmen
- b School of Electrical Engineering and Computer Science , Washington State University , Pullman , WA , USA
| | - Diane Cook
- b School of Electrical Engineering and Computer Science , Washington State University , Pullman , WA , USA
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McAlister C, Schmitter-Edgecombe M. Everyday functioning and cognitive correlates in healthy older adults with subjective cognitive concerns. Clin Neuropsychol 2016; 30:1087-103. [PMID: 27240886 DOI: 10.1080/13854046.2016.1190404] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Few studies have examined functional abilities and complaints in healthy older adults (HOAs) with subjective cognitive concerns (SCC). The aims of this study were to assess everyday functioning in HOAs reporting high and low amounts of SCC and examine cognitive correlates of functional abilities. METHOD Twenty-six HOAs with high SCC and 25 HOAs with low SCC, as well as their knowledgeable informants, completed the Instrumental Activities of Daily Living-Compensation (IADL-C), a questionnaire measure of everyday functioning. RESULTS After controlling for depression, the high-SCC group self-reported significantly more everyday difficulties on the IADL-C, including all subdomains. Compared to the low-SCC group, informants for the high-SCC group endorsed more difficulties on the IADL-C and specifically the social skills subdomain. For the high-SCC group, poorer self-report of everyday functioning was related to poorer executive functioning and temporal order memory. CONCLUSIONS These findings indicate that there may be subtle functional changes that occur early in the spectrum of cognitive decline in individuals with high SCC, and these functional changes are evident to informants. Further work is needed to investigate whether individuals with both SCC and functional difficulties are at an even higher risk for progression to mild cognitive impairment.
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Affiliation(s)
- Courtney McAlister
- a Department of Psychology , Washington State University , Pullman , WA , USA
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McAlister C, Schmitter-Edgecombe M. Executive function subcomponents and their relations to everyday functioning in healthy older adults. J Clin Exp Neuropsychol 2016; 38:925-40. [PMID: 27206842 DOI: 10.1080/13803395.2016.1177490] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures than did young-old participants. For the HOAs, after controlling for age and education, the neuropsychological measures of executive functioning, but not experimental measures, explained a significant amount of variance in the informant-report and both performance-based measures. Updating measures differentially predicted performance-based measures, while switching was important for questionnaire and performance-based measures. The contribution of executive functioning to functional status when measured with experimental measures specifically designed to isolate the executive subcomponent was not as strong as hypothesized. Further research examining the value of isolating executive function subcomponents in neuropsychological assessment and the prediction of functional abilities in older adults is warranted.
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Affiliation(s)
- Courtney McAlister
- a Department of Psychology , Washington State University , Pullman , WA , USA
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