Older adults with mild cognitive impairment (MCI) often have difficulty performing complex instrumental activities of daily living (IADLs), which are critical to independent living. In this study, amnestic multi-domain MCI (N = 29), amnestic single-domain MCI (N = 18), and healthy older participants (N = 47) completed eight scripted IADLs (e.g., cook oatmeal on the stove) in a smart apartment testbed. We developed and experimented with a graded hierarchy of technology-based prompts to investigate both the amount of prompting and type of prompts required to assist individuals with MCI in completing the activities. When task errors occurred, progressive levels of assistance were provided, starting with the lowest level needed to adjust performance. Results showed that the multi-domain MCI group made more errors and required more prompts than the single-domain MCI and healthy older adult groups. Similar to the other two groups, the multi-domain MCI group responded well to the indirect prompts and did not need a higher level of prompting to get back on track successfully with the tasks. Need for prompting assistance was best predicted by verbal memory abilities in multi-domain amnestic MCI. Participants across groups indicated that they perceived the prompting technology to be very helpful. (JINS, 2013, 19, 1–11)

Purpose: Traumatic brain injury (TBI) often leads to executive functions deficits, which may be responsible for severe and longstanding disabilities in everyday activities. Sensitivity and ecological validity of neuropsychological tests of executive functions have been questioned. The aims of this study were to pilot an ecological open-ended assessment of executive functions in children, the ‘Children's Cooking Task’ (CCT), specifically to report its reliability, discriminant validity and concurrent validity. Methods: Twenty-five children with mild (n = 10) or moderate-to-severe TBI (n = 15), and 21 matched controls (aged 8 to 20 years) participated in the study. An open-ended cooking task was designed to test multi-tasking abilities. It required the preparation of two simple recipes using specific instructions. Outcome measures included the number of errors and an overall qualitative analysis of the task. Validating measures of executive functions included the Delis Kaplan Executive Function System, the Six-Part Test and two questionnaires completed by the child's primary care-giver: the Behavior Rating Inventory of Executive Function and the Dysexecutive Questionnaire for Children. Results: Internal consistency of the Children's Cooking Task was high (Cronbach's alpha = .86), as was test–retest reliability (ICC = .89). Children with moderate-to-severe TBI, as well as children with mild TBI made significantly more errors in the Children's Cooking Task in comparison to controls (p < .001). The CCT was correlated with several tests and one questionnaire of executive functioning (Trails, verbal fluency, sorting, 20 questions, Dysexecutive Questionnaire). Discussion and Conclusion: The Children's Cooking Task has good interrater and test–retest reliability, as well as good discriminant and concurrent validity.

The detection of executive deficits in early behavioral variant frontotemporal dementia (bvFTD) is crucial, as impairments in the executive domain constitute an important diagnostic feature of the newly proposed diagnostic criteria for bvFTD. Our group has recently demonstrated that classical executive tests fail to detect the executive deficits of a subgroup of early bvFTD patients. When administered an executive and social cognition battery (ESCB) that includes tasks that mimic everyday scenarios (e.g., affective decision-making, planning and organization, theory of mind), however, the performance of those bvFTD patients differed significantly from that of controls. One limitation of the ESCB is its lengthy nature (approximately 90 min). For this reason, the present study analyzes the usefulness of alternative shorter versions of this battery. We propose one particular two-task combination that demands approximately 30 min for its administration and scoring, and which presents similar discriminatory accuracy as that of the complete ESCB, while maintaining its significantly superior capacity to detect subtle executive deficits in bvFTD patients relative to classical executive tests. We suggest that, in clinical settings where tools, time, or human resources are scarce, this abbreviated ESCB may be useful in the detection of subtle yet impairing executive impairments of patients with bvFTD. (JINS, 2010, 16, 687–694.)