Performance-based instrument to assess functional capacity in community-dwelling older adults

Abstract

Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. Objective: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. Methods: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL’s). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. Results: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. Conclusion: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

The Figure Memory Test: diagnosis of memory impairment in populations with heterogeneous educational background

“…Significant correlations were found between scores in the UPSA and CDT and Verbal Fluency tests but not with the FMT scores. 62 …”

“…Significant correlations were found between scores in the UPSA and CDT and Verbal Fluency tests but not with the FMT scores. 62 Cognitive deficits may be present in patients with mild traumatic brain injury (mTBI) in the first 24 hours after trauma (aTBI). For investigating the presence of cognitive deficits, the FMT of the BCSB, MMSE, Frontal Assessment Battery, and digit-span were used.…”

Mild cognitive impairment history and current procedures in low- and middle-income countries: a brief review

“…60 Other downsides that can influence individual performance are the novelty of the environment and even the evaluator's presence. 60 Examples of performance-based tools used to assess functional capacity in older adults are the UCSD Performance-based Skills Assessment (UPSA), whose results correlate with cognitive measures and evaluates five domains (comprehension and planning, finance, communication, transportation, and household chores), 77 and the Revised Observed Test of Daily Living, which evaluates medication management, using the telephone and managing finances, but does not show a correlation with cognitive performance. 53 All types of assessment have downsides and benefits, and the evaluator must be aware of them to choose the best option for a given objective and interpret the results correctly, whereas for diagnosis purposes or intervention planning.…”

Patterns of instrumental activities of daily living between community-dwelling older adults

“…6,7 Cognitive skills seem to be a relevant aspect of functionality since they are related to performance in IADL. 8,9 At present, additional studies cite the well-established influence of variables such as age and education on levels of independence while others discuss the relationship between FC to other factors such as ethnicity, social class, and distinct health conditions, in addition to gender. [10][11][12][13] However, despite the diversity of studies discussing FC, it is also possible to observe a tendency to work with the total scores of the instruments, classifying the population as partially/totally dependent or independent based on their final results.…”