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

Paula

et al. 2014

Front. Aging Neurosci.

Pfeffer's Functional Activities Questionnaire (FAQ) is one of the most commonly employed tools in studies on pathological cognitive aging. Despite the different versions of the questionnaire translated for use in clinical practice, few studies have analyzed the psychometric properties of the Brazilian version of the FAQ (P-FAQ). Thus, the aim of the present study was to analyze the P-FAQ with regard to internal consistency, factorial structure and associations with demographic factors (age, sex, and schooling), depressive symptoms, cognitive measures and other measures of functionality. One hundred sixty-one older adults were divided into four groups (91 with dementia, 46 with mild cognitive impairment, 11 with psychiatric disorders and 13 healthy controls). All participants were evaluated by cognitive, behavioral and functional tests and scales. Their caregivers answered the P-FAQ. The questionnaire showed high internal consistency (α = 0.91). Factor analysis revealed a two-factor structure, which, accounted for 66% of the total variance. The P-FAQ was not correlated with demographic factors, was weakly correlated with depressive symptoms ( = 0.271, p < 0.01, R 2 = 7%) and strongly correlated with cognitive measures (Matttis Dementia Rating Scale total score: = −0.574, p < 0.01, R 2 = 33%) as well as complex instrumental activities of daily living ( = −0.845, p < 0.01, R 2 = 71%). Cognitive performance and depression status were independent predictors of P-FAQ scores in regression models. The present findings indicate that the P-FAQ has satisfactory reliability, internal consistency, construct validity and ecological validity. Therefore, this questionnaire can be used in clinical practice and research involving the Brazilian population of older adults.

Section: Discussionmentioning

confidence: 88%

Psychometric properties of the Brazilian version of Pfeffer's Functional Activities Questionnaire

Paula

et al. 2014

Front. Aging Neurosci.

“…Different aspects of executive functions such as planning, cognitive flexibility, and selective attention were associated with transportation in the study of Jeferson et al (2006). Deficits in these functions were associated with impairment in “visually” dependent activities such as driving, orientation, and transport use ( Silva et al, 2009 ; Farley et al, 2011 ). However, despite the expected relationship between visuospatial abilities and the ability to travel long distances, few studies have found a significant direct association between the neuropsychological performance and its functional counterpart.…”

Section: Discussionmentioning

confidence: 99%

“…However, other cognitive functions may contribute to specific aspects of ADL. Cognitive measures of spatial processing predicted participants’ performance in an ecological measure of visuospatial abilities in which the subject had to estimate distances, positions, and directions in a “real-life” setting developed by Farley et al (2011) . Activities demanding communicative skills were related to semantic process and language ( Razani et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

Paula

Diniz

Bicalho

et al. 2015

Front. Aging Neurosci.

Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity.

Journal of Clinical and Experimental Neuropsychology

“…Similarly, in EPT test takers solve problems in seven domains, such as food preparation, medication usage, and telephone communication. All three measures have been previously validated, established as reliable, and are widely used to assess IADL competence (Burton, Strauss, Bunce, Hunter, & Hultsch, 2009; Edwards et al, 2005b; Farley, Higginson, Sherman, & MacDougall, 2011; Goverover, Genova, Hillary, & DeLuca, 2007; Jobe et al, 2001; Pressler et al, 2011; Yam & Marsiske, 2013). Performance across these three IADL tests is intercorrelated (e.g., Sartori et al, 2012), and each is associated with UFOV performance (Owsley et al, 2002; Sartori et al, 2012).…”

mentioning

confidence: 99%

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

Aust

Edwards

2016

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.