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Cognitive Correlates of Functional Performance in Older Adults: Comparison of Self-Report, Direct Observation, and Performance-Based Measures

Published online by Cambridge University Press:  27 June 2011

Maureen Schmitter-Edgecombe ,
Carolyn Parsey  and
Diane J. Cook
Maureen Schmitter-Edgecombe*
Affiliation:
Department of Psychology, Washington State University, Pullman, Washington
Carolyn Parsey
Affiliation:
Department of Psychology, Washington State University, Pullman, Washington
Diane J. Cook
Affiliation:
School of Electrical Engineering and Computer Science, Washington State University, Pullman, Washington
*
Correspondence and reprint requests to: Maureen Schmitter-Edgecombe, Department of Psychology, Washington State University, P.O. Box 644820, Pullman, WA 99164-4820. E-mail: [email protected].
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Abstract

Neuropsychologists are often asked to answer questions about the effects of cognitive deficits on everyday functioning. This study examined the relationship between and the cognitive correlates of self-report, performance-based, and direct observation measures commonly used as proxy measures for everyday functioning. Participants were 88 community-dwelling, cognitively healthy older adults (age 50–86 years). Participants completed standardized neuropsychological tests and questionnaires, and performed eight activities of daily living (e.g., water plants, fill a medication dispenser) while under direct observation in a campus apartment. All proxy measures of everyday function were sensitive to the effects of healthy cognitive aging. After controlling for age, cognitive predictors explained a unique amount of the variance for only the performance-based behavioral simulation measure (i.e., Revised Observed Tasks of Daily Living). The self-report instrumental activities of daily living (IADL) and the performance-based everyday problem-solving test (i.e., EPT) did not correlate with each other; however, both were unique predictors of the direct observation measure. These findings suggest that neuropsychologists must be cautious in making predictions about the quality of everyday activity completion in cognitively healthy older adults from specific cognitive functions. The findings further suggest that a self-report of IADLs and the performance-based EPT may be useful measures for assessing everyday functional status in cognitively healthy older adults. (JINS, 2011, 17, 853–864)

Keywords

Activities of daily livingCognitive correlatesFunctional statusAgingInstrumental activities of daily livingEveryday functioning
Type
Regular Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 5 , September 2011 , pp. 853 - 864
Copyright
Copyright © The International Neuropsychological Society 2011

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References

Allaire, J.C., Marsiske, M. (1999). Everyday cognition: Age and intellectual ability correlates. Psychology and Aging, 14(4), 627–644.CrossRefGoogle ScholarPubMed
Allaire, J.C., Marsiske, M. (2002). Well- and ill-defined measures of everyday cognition: Relationship to older adults’ intellectual ability and functional status. Psychology and Aging, 17(1), 101–115.CrossRefGoogle ScholarPubMed
Alexander, N.B., Guire, K.E., Thelen, D.G., Ashton-Miller, J.A., Schultz, A.B., Grunwalt, J.C., Giordani, B. (2000). Self-reported walking ability predicts functional mobility performance in frail older adults. Journal of the American Geriatrics Society, 48, 1408–1413.CrossRefGoogle ScholarPubMed
Bell-McGinty, S., Podell, K., Franzen, M., Baird, A.D., Williams, M.J. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17(9), 828–834.CrossRefGoogle ScholarPubMed
Bertrand, R.M., Willis, S.L. (1999). Everyday problem solving in Alzheimer's patients: A comparison of subjective and objective assessments. Aging & Mental Health, 3, 281–293.CrossRefGoogle Scholar
Brandt, J., Folstein, M. (2003). Telephone interview for cognitive status. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Burton, C.A., Strauss, E., Bunce, D., Hunter, M.A., Hultsch, D.F. (2009). Functional abilities in older adults with mild cognitive impairment. Gerontology, 55, 570–581.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D.A., Boyle, P.A., Malloy, P.F. (2002). Tests of executive function predict instrumental activities of daily living in community dwelling older individuals. Applied Neuropsychology, 9(3), 187–191.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D.A., Farias, S.T., Julian, L., Harvey, D.J., Kramer, J.H., Reed, B.R., Chui, H. (2007). Cognitive and neuroimaging predictors of instrumental activities of daily living. Journal of the International Neuropsychological Society, 13(5), 747–757.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D., Malloy, P., Boyle, P., Marran, M., Salloway, S. (2000). Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. The Clinical Neuropsychologist, 14, 187–195.CrossRefGoogle ScholarPubMed
Cho, C., Alessi, C., Cho, M., Aronow, H., Stuck, A., Rubenstein, L., Beck, J. (1998). The association between chronic illness and functional change among participants in a comprehensive geriatric assessment program. Journal of the American Geriatrics Society, 46, 677–682.CrossRefGoogle Scholar
Cullum, C.M., Saine, K., Chan, L.D., Martin-Cook, K., Gray, K.F., Weiner, M.F. (2001). Performance-based instrument to assess functional capacity in dementia: The Texas Functional Living Scale. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14, 103–108.Google ScholarPubMed
Dassel, K.B., Schmitt, F.A. (2008). The impact of caregiver executive skills on reports of patient functioning. The Gerontological Society of America, 48, 781–792.Google ScholarPubMed
Delis, D.C., Kaplan, E., Kramer, J.H. (2001). Delis-Kaplan Executive Function System: Examiner's manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Diehl, M., Marsiske, M., Horgas, A., Rosenberg, A., Saczynski, J., Willis, S. (2005). The revised observed tasks of daily living: A performance-based assessment of everyday problem solving in older adults. Journal of Applied Gerontology, 24, 211–230.CrossRefGoogle ScholarPubMed
Farias, S.T., Harrell, E., Neumann, C., Houtz, A. (2003). The relationship between neuropsychological performance and daily functioning in individuals with Alzheimer's disease: Ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology, 18, 655–672.CrossRefGoogle ScholarPubMed
Farias, S.T., Mungas, D., Jagust, W. (2005). Degree of discrepancy between self and other-reported everyday functioning by cognitive status: Dementia, mild cognitive impairment, and healthy elders. International Journal of Geriatric Psychiatry, 20, 827–834.CrossRefGoogle ScholarPubMed
Farias, S.T., Mungas, D., Reed, B., Harvey, D., Cahn-Weiner, D., DeCarli, C. (2006). MCI is associated with deficits in everyday functioning. Alzheimer Disease and Associated Disorders, 20, 217–223.CrossRefGoogle ScholarPubMed
Galanos, A.N., Fillenbaum, G.G., Cohen, H.J., Burchett, B.M. (1994). The comprehensive assessment of community dwelling elderly: Why functional status is not enough. Aging Clinical and Experimental Research, 6, 343–352.CrossRefGoogle ScholarPubMed
Giovannetti, T., Libon, D.J., Buxbaum, L.J., Schwartz, M.F. (2002). Naturalistic action impairments in dementia. Neuropsychologia, 40, 1220–1232.CrossRefGoogle ScholarPubMed
Glosser, G., Gallo, J., Duda, N., de Vries, J.J., Clark, C.M., Grossman, M. (2002). Visual perceptual functions predict instrumental activities of daily living in patients with dementia. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 15, 198–206.Google ScholarPubMed
Goldstein, G. (1996). Functional considerations in neuropsychology. In R.J. Sbordone & C.J. Long (Eds.), Ecological validity of neuropsychological testing (pp. 75–89). Delray Beach, FL: GR Press/St Lucie Press.Google Scholar
Guccione, A., Felson, D., Anderson, J., Anthony, J., Zhang, Y., Wilson, P., Kannel, W. (1994). The effects of specific medical conditions on the functional limitation of elders in the Framingham study. American Journal of Public Health, 84, 351–358.CrossRefGoogle ScholarPubMed
Hayes, T.L., Abendroth, F., Adamid, A., Pavela, M., Zitzelberger, T.A., Kaye, J.A. (2008). Unobtrusive assessment of activity patterns associated with mild cognitive impairment. Alzheimer's & Dementia, 4, 395–405.CrossRefGoogle ScholarPubMed
Hughes, C.P., Berg, L., Danzinger, W.L., Coben, L.A., Martin, R.L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Inzarti, D., Basile, A.M. (2003). Activities of daily living and global functioning. International Psychogeriatrics, 15, 225–229.Google Scholar
Ivnik, R.J., Malec, J.F., Smith, G.E., Tangalos, E.G., Petersen, R.C. (1996). Neuropsychological testing norms above age 55: COWAT, BNT, MAE TOKEN, WRAT-R Reading, AMNART, Stroop, TMT, and JLO. The Clinical Neuropsychologist, 10, 262–278.CrossRefGoogle Scholar
Jefferson, A.L., Barakat, L.P., Giovannetti, T., Paul, R.H., Glosser, G. (2006). Object perception impairments predict instrumental activities of daily living dependence in Alzheimer's disease. Journal of Clinical and Experimental Neuropsychology, 28(6), 884–897.CrossRefGoogle ScholarPubMed
Jefferson, A.L., Byerly, L.K., Vanderhill, S., Lambe, S., Wong, S., Oznoff, A., Karlawish, J.H. (2008). Characterization of activities of daily living in individuals with mild cognitive impairment. The American Journal of Geriatric Psychiatry, 16(5), 375–383.CrossRefGoogle ScholarPubMed
Kempen, G., Sterverink, N., Ormel, J., Deeg, D. (1996). The assessment of ADL among frail elderly in an interview survey: Self-report versus performance based tests and determinants of discrepancies. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 51, 254–260.CrossRefGoogle Scholar
Lafortune, G., Balestat, G. (2007). Trends in severe disability among elderly people: Assessing the evidence in 12 OECD countries and the future implications. OECD Health Working Papers, No 26, OECD Publishing.Google Scholar
Lawton, M., Moss, M., Fulcomer, M., Kleban, M. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37(1), 91–99.CrossRefGoogle ScholarPubMed
Lewis, M.S., Miller, L.S. (2007). Executive control functioning and functional ability in older adults. The Clinical Neuropsychologist, 21(2), 274–285.CrossRefGoogle ScholarPubMed
Loewenstein, D., Acevedo, A. (2010). The relationship between instrumental activities of daily living and neuropsychological performance. In T.D. Marcotte & I. Grant (Eds.), Neuropsychology of everyday functioning (pp. 93–112). New York: The Guilford Press.Google Scholar
Loewenstein, D.A., Arguelles, S., Bravo, M., Freeman, R.Q., Arguelles, T., Acevedo, A., Eisdorfer, C. (2001). Caregivers’ judgments of the functional abilities of the Alzheimer's disease patient: A comparison of proxy reports and objective measures. The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 56, P78–P84.CrossRefGoogle Scholar
Marcotte, T.D., Scott, J.C., Kamat, R., Heaton, R.K. (2010). Neuropsychology and the prediction of everyday functioning. In T.D. Marcotte & I. Grant (Eds.), Neuropsychology of everyday functioning (pp. 5–38). New York: The Guilford Press.Google Scholar
Marson, D., Hebert, K. (2006). Functional assessment. In D. Attix & K. Welsh-Bohmer (Eds.), Geriatric Neuropsychology Assessment and Intervention (pp. 158–189). New York: The Guilford Press.Google Scholar
McCue, M., Rogers, J.C., Goldstein, G. (1990). Relationships between neuropsychological and functional assessment in elderly neuropsychiatric patients. Rehabilitation Psychology, 35(2), 91–99.CrossRefGoogle Scholar
Morris, J.C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Myers, A., Holliday, P., Harvey, K., Hutchinson, K. (1993). Functional performance measures: Are they superior to self-assessments? Journal of Gerontology, 48, M196–M206.CrossRefGoogle ScholarPubMed
Rashidi, P., Cook, D.J., Holder, L.B., Schmitter-Edgecombe, M. (2011). Discovering activities to recognize and track in a smart environment. IEEE Transactions on Knowledge and Data Engineering, 23, 527–539.CrossRefGoogle Scholar
Reuben, D., Valle, L., Hays, R., Siu, A. (1995). Measuring physical function in community dwelling older persons: A comparison of self-administered, interviewer-administered, and performance-based measures. Journal of the American Geriatrics Society, 43, 17–23.CrossRefGoogle Scholar
Richardson, E., Nadler, J., Malloy, P. (1995). Neuropsychologic prediction of performance measures of daily living skills in geriatric patients. Neuropsychology, 9, 565–572.CrossRefGoogle Scholar
Royall, D.R., Cordes, J.A., Polk, M. (1998). CLOX: An executive clock drawing task. Journal of Neurology, Neurosurgery, and Psychiatry, 64, 588–594.CrossRefGoogle ScholarPubMed
Royall, D.R., Lauterbach, E.C., Kaufer, D., Malloy, P., Coburn, K.L., Black, K.J. (2007). The cognitive correlates of functional status: A review from the Committee on Research of the American Neuropsychiatric Association. The Journal of Neuropsychiatry and Clinical Neurosciences, 19(3), 249–265.CrossRefGoogle Scholar
Rueda, A., Schmitter-Edgecombe, M. (2011). Everyday functioning in cognitively intact elderly compared to younger adults. Manuscript submitted for publication.Google Scholar
Smith, A. (1991). Symbol Digit Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Suchy, Y., Kraybill, M., Franchow, E. (2011). Instrumental activities of daily living among community-dwelling older adults: Discrepancies between self-report and performance are mediated by cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 33, 92–100.CrossRefGoogle ScholarPubMed
Tuokko, H., Morris, C., Ebert, P. (2005). Mild cognitive impairment and everyday functioning in older adults. Neurocase, 11, 40–47.CrossRefGoogle ScholarPubMed
Wechsler, D. (1997). Wechsler Adult Intelligence Test-third edition. New York, NY: The Psychological Corporation.Google Scholar
Williams, J.M. (1991). Memory Assessment Scales professional manual. Odessa: Psychological Assessment Resources, Inc.Google Scholar
Willis, S., Marsiske, M. (1993). Manual for the Everyday Problems Test. University Park: Department of Human Development and Family Studies, Pennsylvania State University.Google Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., Leirer, V.O. (1983). Development and validation of a geriatric depression rating scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar
Zimmerman, S., Magaziner, J. (1994). Methodological issues in measuring the functional status of cognitively impaired nursing home residents: The use of proxies and performance-based measures. Alzheimer Disease and Associated Disorders, 8, S281–S290.Google ScholarPubMed