Concurrent Validity of Performance-Based Measures of Daily Functioning with Cognitive Measures and Informant Reported...

Area of Science:

• Gerontology
• Neuroscience
• Cognitive Assessment

Background:

• Subtle functional declines in early dementia stages like subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are difficult to assess.
• Existing research on functional ability changes during prodromal dementia is limited.
• There is a need for reliable and valid assessment tools for functional ability in older adults.

Purpose of the Study:

• To characterize subtle, clinically meaningful changes in functional ability using novel performance-based assessments.
• To investigate the utility of performance-based measures in detecting early functional declines in older adults.
• To compare functional performance across cognitively unimpaired (CU), SCD, and MCI groups.

Main Methods:

• A sample of 93 older adults (CU, SCD, MCI) underwent neuropsychological testing.
• An informant-rated daily functional skills measure (Assessment of Functional Capacity Interview) was administered.
• Participants completed performance-based measures: Night Out Task (NOT) and Financial Capacity Instrument-Short Form (FCI-SF).

Main Results:

• The MCI group showed poorer performance on the NOT and FCI-SF compared to SCD and CU groups.
• NOT and FCI scores correlated with global cognitive function, executive function, processing speed, language, and memory.
• The NOT and FCI-SF predicted informant-reported daily functioning beyond traditional cognitive data and demographics.

Conclusions:

• Performance-based measures of instrumental activities of daily living (IADL) may enable earlier detection of subtle functional changes.
• These measures capture functional changes not adequately identified by traditional assessment methods.
• Measuring early functional changes is crucial for evaluating the effectiveness of dementia interventions.