Predictive Utility of Four Instrumental Activities of Daily Living Assessments and Cognitive Status Changes Among Cognitively In-Tact Older Adults.

IF 2.2 3区医学 Q2 GERONTOLOGY Journal of Aging and Health Pub Date : 2024-11-09 DOI:10.1177/08982643241297193

Christine B Phillips, Ava McVey, Briana N Sprague, Kalvry Cooper, Abigail T Stephan, Lesley A Ross

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Abstract

Purpose: To examine the factor structure and predictive utility of four instrumental activities of daily living (IADL) measures to identify cognitive status changes among older adults enrolled in the ACTIVE Trial.

Major findings: Extracted factors represented IADL instruments. Baseline performance on the Everyday Problems Test (EPT) predicted 5-year MMSE scores (est. = .08, p < .001), adjusting for demographic and health covariates, baseline MMSE, self-reported IADL function, and the performance-based Observed Tasks of Daily Living and Timed Instrumental Activities of Daily Living assessments. For each 1-point increase in baseline EPT financial performance, the odds of cognitive impairment decreased by 26%.

Conclusions: IADL functional domains were not interchangeable across instruments. The EPT demonstrated better predictive utility compared to other instruments for detecting subsequent cognitive decline/impairment. This is a useful step in developing effective tools to detect early functional deficits indicating subsequent clinical impairment. Advanced Cognitive Training for Independent and Vital Elderly Trial (ACTIVE), NCT00298558, https://clinicaltrials.gov/study/NCT00298558.

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四种工具性日常生活活动评估的预测效用与认知障碍老年人的认知状态变化。

目的：研究四种工具性日常生活活动（IADL）测量方法的因子结构和预测效用，以确定参加 ACTIVE 试验的老年人的认知状况变化：提取的因子代表了 IADL 工具。日常问题测试（EPT）的基线表现预测了5年的MMSE得分（est. = .08，p < .001），调整了人口统计学和健康协变量、基线MMSE、自我报告的IADL功能以及基于表现的日常生活观察任务和定时日常生活工具活动评估。基线EPT财务表现每提高1分，认知障碍的几率就会降低26%：不同工具的 IADL 功能域不可互换。与其他工具相比，EPT 在检测后续认知能力下降/受损方面具有更好的预测效用。这对于开发有效工具以检测早期功能障碍、预示后续临床损害非常有用。独立和活力老人高级认知训练试验（ACTIVE），NCT00298558，https://clinicaltrials.gov/study/NCT00298558。

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来源期刊

Journal of Aging and Health Multiple-

CiteScore

5.60

自引率

3.60%

发文量

113

期刊介绍： The Journal of Aging and Health is an interdisciplinary forum for the presentation of research findings and scholarly exchange in the area of aging and health. Manuscripts are sought that deal with social and behavioral factors related to health and aging. Disciplines represented include the behavioral and social sciences, public health, epidemiology, demography, health services research, nursing, social work, medicine, and related disciplines. Although preference is given to manuscripts presenting the findings of original research, review and methodological pieces will also be considered.