The current study examined the relationship between neuropsychological test performance and functional status in 42 individuals diagnosed with Alzheimer's disease. A comprehensive battery of cognitive tests was employed in order to assess a wide range of neuropsychological abilities. Functional status was measured through the use of both a performance-based scale of activities of daily living (an expanded version of the Direct Assessment of Functional Status; DAFS, Loewenstein et al., 1989), and by a caregiver/informant-based rating scale (Instrumental Activities of Daily Living; IADL, Lawton & Brody, 1969). Findings suggest that neuropsychological functioning is moderately predictive of functional status. Using multiple regression analyses, neuropsychological variables accounted for 25% of the variance in the IADL and 50% of the variance in the DAFS. Individual domains of both functional measures were also significantly predicted by the neuropsychological variables. The findings provide evidence of a relationship between neuropsychological test performance and ADLs in an Alzheimer disease patient population.

Studies indicate that executive functioning (EF) is a strong predictor of everyday function. However, assessment can be problematic as no single standardized instrument is known to measure all EF domains simultaneously. Thus, the Pillbox Test was developed as a new measure tapping four EF factors through the real-time assessment of medication management, a complex instrumental activity of daily living. The Pillbox Test showed good criterion-related validity and was effective in differentiating graduated levels of executive dysfunction between a mixed neurological group, medical control group, and healthy community control group. This test also showed good convergent validity as it correlated significantly in expected directions with established EF measures in all four of selected EF domains and the Direct Assessment of Functional Status. Finally, a receiver operator characteristic curve found a sensitivity of 75% and specificity of 87.5%, suggesting that the Pillbox Test is a promising new ecological measure of EF.

Road accidents and falls often result in injury to the dominant hand; however, few studies have evaluated whether the use of the nondominant hand confounds pen and paper assessments. This study used a counterbalanced within-subjects design to assess the copy accuracy on the Rey Complex Figure Test (RCFT) of 154 undergraduates using both their right and left hands. Handedness was determined using Briggs and Nebes's (1975) revision of Annett's Handedness Questionnaire. Two independent scorers used objective scoring criteria (Meyers& Meyers, 1995) with high interscorer reliability. Performance differences were statistically but not clinically significant. Nondominant- and dominant-hand performances did not differ from normative data: A total of 78.9% scored above the impairment cutoff score using the nondominant hand compared to 83.7% using their dominant hand. In the event an individual's dominant hand is compromised, performance using the nondominant hand on the RCFT could produce scores within the normative range and would not falsely suggest neuropsychological impairment.

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