Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

Abstract

Introduction The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults’ ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions and the underlying constructs of UFOV performance remain a topic of debate. Method We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We, then, explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study. Results In the four subtest variant of UFOV, only subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general non-speeded cognition, and visual function; the omission of subtests 1 and 4 from the test score did not affect these associations. Conclusions UFOV subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future experimental research should investigate if shortening the UFOV by omitting these subtests is a reliable and valid assessment approach.

Useful Field of View Performance in the Intact Visual Field of Hemianopia Patients

“…Indeed, a floor effect has been reported for healthy participants in the past. 21,36,37 Yet, whereas healthy control participants in our study all reached the lowest, that is, best score, some patients did not. Furthermore, patients who were not included in the analyses because they were unable to finish all three iUFOV subtests did show reduced performance on this subtest.…”

“…This method forced all participants to spread their attention across the visual field as in daily life, thus maintaining the ecological validity of the standard UFOV test. 19 – 21 Note that by presenting eight alternatives, the guessing correct probability for stimulus locations was still 1/8 (as in the standard UFOV) resulting in an overall guess rate of 1/16 for the identification and localization task combined for patients and control participants alike. To ensure that peripheral stimuli presented on the left or right side of the screen appeared in the subjects’ left or right hemifield, participants had to fixate inside the fixation box until the stimulus display had disappeared.…”

“…Previous research showed relationships between performance on the UFOV test and many perceptual and cognitive functions (for a review see 18 ) as well as daily life activities. 19 – 21 For example, UFOV performance predicts driving ability as well as the speed at which everyday living tasks can be performed, such as counting spare change and reading ingredients on a food can. Although the observed relations differ between populations and activities, 20 , 22 , 23 these findings suggest that the UFOV may be able to explain difficulties experienced by patients with hemianopia that cannot be explained by perimetry outcomes alone.…”

A meta-analysis of perceptual and cognitive functions involved in useful-field-of-view test performance

“…Although attention shows stronger correlations with UFOV2 and UFOV3 than UFOV1, as mentioned before, this is a general effect of UFOV on all domains. This difference in correlation strengths could be due to the floor effect that is often observed in UFOV1 (Aust & Edwards, 2016;Edwards et al, 2006). Because healthy people can easily achieve the best (i.e., lowest) score on UFOV1, there is little variation in the test results, and strong correlations between UFOV1 and other test scores are therefore less likely to be found.…”

“…Currently, the UFOV test consists of three subtests that measure different aspects of cognitive and visual processes by determining the minimal presentation duration that a subject needs to make correct decisions regarding the content of a visual stimulus on 75% of the trials (Figure 1; Aust & Edwards, 2016;Visual Awareness Research Group, 2009). Shorter stimulus presentation durations therefore represent better performance.…”