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Clinical Manifestations.

Keerthana Bengaluru Somashekar1, Aparna Lalana Venugopal1, Nithin Thanissery1

  • 1National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
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Summary
This summary is machine-generated.

Performance Based Assessment (PBA) effectively differentiates cognitive impairment in mild cognitive impairment (MCI) and dementia patients using real-life tasks. These ecologically valid measures are crucial for accurate diagnosis across diverse populations.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Gerontology

Background:

  • Cognitive impairments often manifest as difficulties in daily activities.
  • Traditional cognitive tests are often paper-based, favoring educated individuals.
  • There is a need for ecologically valid, person-centered assessments for cognitive impairment.

Purpose of the Study:

  • To develop and validate a Performance Based Assessment (PBA) for identifying cognitive deficits in real-life situations.
  • To assess executive functions in individuals with mild cognitive impairment (MCI) and dementia.
  • To evaluate the PBA's effectiveness across diverse demographic groups.

Main Methods:

  • A scoping review identified suitable tasks for PBA development.
  • Three tasks (cooking, packing, shopping) were finalized and expert-validated.
  • Participants (cognitively normal, MCI, dementia) completed PBA tasks, sociodemographic assessments, and standard cognitive/functional evaluations (ACE-III, CDR, IADL).

Main Results:

  • The PBA demonstrated good interrater reliability and internal consistency (Cronbach's alpha >0.7).
  • Dementia patients exhibited significantly more errors and longer completion times compared to MCI and cognitively normal groups.
  • PBA outcomes correlated negatively with standard cognitive scores (ACE-III, CDR, CDI), indicating sensitivity to cognitive decline.

Conclusions:

  • The developed PBA successfully distinguished between cognitively normal, MCI, and dementia groups.
  • The tasks are relevant across various demographics, including literacy and socioeconomic backgrounds, suitable for diverse societies.
  • PBA enhances the detection of cognitive impairment in complex daily activities, supporting clinical application.