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Updated: Sep 17, 2025

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
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Functional cognitive performance augments cognitive screening data in older adults.

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Cognitive ability in older adults significantly impacts instrumental activities of daily living (IADL) performance. Comprehensive assessments should include both cognitive and performance-based IADL evaluations for accurate care planning.

Keywords:
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Area of Science:

  • Gerontology
  • Neuroscience
  • Public Health

Background:

  • Understanding the link between cognitive function and daily living activities in older adults is crucial for healthcare.
  • Instrumental Activities of Daily Living (IADL) are essential for independent community living.
  • Cognitive impairment can significantly affect an older adult's ability to perform IADLs.

Purpose of the Study:

  • To compare instrumental activities of daily living (IADL) performance scores in older adults based on their cognitive ability.
  • To investigate the association between cognitive status, measured by the Montreal Cognitive Assessment (MoCA), and performance-based IADL assessments.

Main Methods:

  • Cross-sectional analysis of 259 community-dwelling older adults (aged 55-93).
  • Participants categorized into three groups based on Montreal Cognitive Assessment (MoCA) scores: mildly impaired (19-22), borderline (23-25), and unimpaired (26-30).
  • Instrumental Activities of Daily Living (IADL) assessed using the Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST) and the Weekly Calendar Planning Activity (WCPA-17).

Main Results:

  • A significant difference in IADL performance was found among the MoCA cognitive groups (MANCOVA, p < 0.001).
  • Both PCST Total Cues and WCPA-17 Accuracy scores differed significantly across MoCA groups (p < 0.001), with medium-large effect sizes.
  • Individuals with borderline or unimpaired MoCA scores sometimes demonstrated difficulties in complex IADLs.

Conclusions:

  • The Montreal Cognitive Assessment (MoCA) categorization aligns with performance on IADL tasks.
  • Performance-based IADL assessments are vital for identifying functional deficits, even in older adults with borderline or unimpaired cognitive scores.
  • Integrated cognitive and performance-based assessments are recommended for comprehensive evaluations of older adults' needs.