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Impact of familiar and unfamiliar settings on cooking task assessments in frail older adults with poor and preserved executive functions

Published online by Cambridge University Press:  12 December 2011

Véronique Provencher ,
Louise Demers ,
Lise Gagnon  and
Isabelle Gélinas
Véronique Provencher*
Affiliation:
Research Center, Institut universitaire de gériatrie de Montréal, School of Rehabilitation, Université de Montréal, Montréal, Canada
Louise Demers
Affiliation:
Research Center, Institut universitaire de gériatrie de Montréal, School of Rehabilitation, Université de Montréal, Montréal, Canada
Lise Gagnon
Affiliation:
Research Center on Aging, Sherbrooke Geriatric University Institute, Department of Psychology, Université de Sherbrooke, Sherbrooke, Canada
Isabelle Gélinas
Affiliation:
School of Physical and Occupational Therapy, McGill University, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
*
Correspondence should be addressed to: Véronique Provencher, Research Center, Institut universitaire de gériatrie de Montréal, 4565 Queen Mary, Montreal, Quebec, CanadaH3W 1W5. Phone: +1-514-340-3540 ext. 4004; Fax: +1-514-340-3548. Email: [email protected].
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Abstract

Background: Hospitalized frail older patients are usually assessed for their ability to perform some daily living activities in a clinical setting prior to discharge. However, assessments that take place in this unfamiliar environment might not be as representative of their functional performance as assessments at home. This may be related to a decline in some cognitive components, such as executive functions (EF), which enable one to cope with new environments. This study thus aims to compare cooking task performance in familiar and unfamiliar settings in a population of frail older adults with poor and preserved EF.

Methods: Thirty-seven frail older adults were assigned to one of two groups: poor EF or preserved EF. Participants performed two cooking tasks in familiar and unfamiliar settings, using a counterbalanced design. Their performance was assessed with a reliable tool based on observation of motor and process skills (Assessment of Motor and Process Skills).

Results: Thirty-three participants were retained for analysis. They demonstrated significantly better motor skills (F = 5.536; p = 0.025) and process skills (F = 8.149; p = 0.008) in the familiar setting. The difference between settings was particularly marked for process skills in participants with poor EF (F = 16.920; p < 0.001).

Conclusions: This study suggests that a home setting may be preferable for a more accurate assessment of cooking task performance in frail older adults, especially those with poor EF. These findings highlight the risk of underestimating frail older adults’ performance when assessed in an unfamiliar setting (e.g. hospital), which could lead to inefficient allocation of home care services.

Keywords

frailtyexecutive functionsactivity of daily livingperformance-based assessmentenvironment
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 5 , May 2012 , pp. 775 - 783
Copyright
Copyright © International Psychogeriatric Association 2011

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