Neuropsychological Predictors of Adaptive Kitchen Behavior in Geriatric Psychiatry Inpatients

Abstract

This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. Amixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both depression and dementia were prevalent among patients. The kitchen skills assessment was abnormal in 69% of patients, compared to none of the normal volunteers. Estimated premorbid IQs, psychiatric diagnosis, and neuropsychological test scores significantly predicted the pass/fail status on the kitchen skills assessment, but there was no effect for age, education, gender, or depression. The discriminant function analysis classified 92% of cases, and the canonical correlation coefficient was .84. Of the neuropsychological tests employed in the study, two tests involving visuospatial processing and attention were retained in the discriminant function analysis. The results are consistent with previous studies that suggest that visuospatial tasks are more predictive of instrumental activities of daily living than are cognitive tasks emphasizing verbal and memory abilities. In addition, we conclude that neuropsychological test data are useful and valid for the purpose of guiding clinical judgments regarding activities of daily living in geriatric psychiatry patients.

The Ecological Validity of Clinical Tests of Visuospatial Function in Community-Dwelling Older Adults

“…In general, correlations between the neuropsychological measures and the global measure of daily functioning, the OTDL-R, are consistent with previous studies indicating that neuropsychological measures are good predictors of daily function in older adults (Benedict et al, 1997;Cahn-Weiner et al, 2000;Farias et al, 2003;Freilich & Hyer, 2007;Glosser et al, 2002;Hill et al, 1995;Perry & Hodges, 2000;Richardson et al, 1995;Royall et al, 2004). The size of the correlations ranged from .39 to .59, representing medium to large effects (Cohen, 1992).…”

“…The performance of individuals with dementia on an overlapping figures task significantly contributed to the prediction of ADLs (Hill, Backman, & Fratiglioni, 1995). Benedict, Goldstein, Dobraski, and Tannenhaus (1997) reported that a measure of visuospatial function contributed to the prediction of a kitchen task in a mixed sample composed mostly of geriatric psychiatry inpatients. In a sample of individuals early in the course of Alzheimer's disease (AD), visuospatial function was "the sole cognitive predictor" of functional ability (Perry & Hodges, 2000).…”

Everyday Problem Solving among Four Groups of Individuals with Cognitive Impairments: Examination of the Discriminant Validity of the Observed Tasks of Daily Living—Revised

“…In addition to direct IADL performance assessment and self-report or proxy reports, research has shown that neuropsychological test performance can predict IADL performance in older adults with and without dementia and psychiatric disorders. Benedict, Goldstein, Dobraski, and Tannenhaus (1997) found that visuospatial tasks could be good predictors of IADL performance. However, Shallice and Burgess (1991) reported that individuals with frontal lobe damage performed within the normal range on neuropsychological tests and laboratory tasks presumed to rely on executive functions.…”

A grid for a precise analysis of daily activities

“…A complete neuropsychological examination is required to identify each patient's deficits and preserved cognitive functions. Visuospatial tasks are claimed to be "more predictive of instrumental activities of daily living than are cognitive tasks emphasising verbal and memory activities" (Benedict, Goldstein, Dobraski, & Tannenhaus, 1997), and so patients should be tested on both kinds of tasks. Even so, a "psychometric" cognitive evaluation is likely to prove insufficient, because of the lack of ecological validity of this kind of assessment, which generally does not reveal the patient's difficulties with real-life activities: "neuropsychological functioning is moderately predictive of functional status" (Farias, Harrell, Neumann, & Houtz, 2003).…”