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Convergent and concurrent validity of a report- versus performance-based evaluation of everyday functioning in the diagnosis of cognitive disorders in a geriatric population

Published online by Cambridge University Press:  22 March 2018

Elise Cornelis
Affiliation:
Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Brussels Capital, Belgium Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium Department of Occupational Therapy, Artevelde University College Ghent, Ghent, East Flanders, Belgium
Ellen Gorus
Affiliation:
Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Brussels Capital, Belgium Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium Department of Gerontology (GERO), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium
Karen Van Weverbergh
Affiliation:
Department of Gerontology (GERO), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium
Ingo Beyer
Affiliation:
Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Brussels Capital, Belgium Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium Department of Gerontology (GERO), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium
Patricia De Vriendt*
Affiliation:
Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium Department of Occupational Therapy, Artevelde University College Ghent, Ghent, East Flanders, Belgium Department of Gerontology (GERO), Vrije Universiteit Brussel, Brussels, Brussels Capital, Belgium
*
Correspondence should be addressed to: Prof. Patricia De Vriendt, Frailty in Ageing Research Group (FRIA) and Department of Gerontology (GERO), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium. Phone: +32-479-65-41-10; Fax: +32-447-63-64. Email: [email protected].
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Abstract

Background:

Several methods have been developed to evaluate activities of daily living (ADLs) in mild cognitive impairment (MCI) and mild dementia. This study evaluated the convergent and concurrent validity between (1) two report-based methods (the advanced (a)- and instrumental (i)-ADL tools) and (2) a performance-based method (the Naturalistic Action Test (NAT)) to check if their ability to differentiate between cognitively healthy comparisons (HCs), persons with MCI, and persons with mild Alzheimer's disease (AD) are comparable to each other.

Method:

This was a cross-sectional study, undertaken in a geriatric day hospital. The participants comprised community-dwelling HCs (n = 21, median age 78.0 years, 61.9% female), MCI (n = 20, median age 79.5 years, 55.0% female), and AD (n = 20, median age 80.0 years, 85.0% female) adults. A diagnostic procedure for neurocognitive disorders was employed. In addition, the a- and i-ADL tools and the NAT were administered separately by blinded raters.

Results:

The NAT and both the a- and i-ADL tools showed significant differences between HCs, MCI, and AD participants. Convergent validity showed moderate to strong significant correlations between the NAT, and a- and i-ADL tools (range −0.583 to −0.663; p < 0.01). Concurrent validity showed that the NAT (AUC 0.809–1.000) and the a- and i-ADL tools (AUC 0.739–0.964) presented comparable discriminatory accuracy (p = 0.0588).

Conclusions:

In contrast to prior studies comparing report-based and performance-based methods of assessing ADL, this study indicates that the NAT and the a- and i-ADL tools have strong convergent and concurrent validity, and appear to have similar discriminatory power in differentiating between HCs, MCI, and AD.

Type
Original Research Article
Copyright
Copyright © International Psychogeriatric Association 2018 

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References

Allen, C. K., Austin, S. L., David, S. K., Earhart, C. A., McCraith, D. B. and Riska-Williams, L. (2007). Allen Cognitive Level Screen-5 (ACLS-5) and Large Allen Cognitive Level Screen-5 (LACLS-5). Camarillo, CA, USA: ACLS and LACLS Committee.Google Scholar
Andresen, E. M. (2000). Criteria for assessing the tools of disability outcome research. Archives of Psychical Medicine and Rehabilitation, 81, S15–20.Google Scholar
Anstey, K. J. et al. (2013). Characterizing mild cognitive disorders in the young-old over 8 years: prevalence, estimated incidence, stability of diagnosis, and impact on iADLs. Alzheimer's & Dementia, 9, 640648.Google Scholar
Bean, J. F., Olveczky, D. D., Kiely, D. K., LaRose, S. I. and Jette, A. M. (2011). Performance-based versus patient-reported physical function: what are the underlying predictors? Physical Therapy, 91, 18041811.Google Scholar
Bruce, I., Ntholang, O., Crosby, L., Cunningham, C. and Lawlor, B. (2016). The clinical utility of naturalistic action test in differentiating mild cognitive impairment from early dementia in memory clinic. International Journal of Geriatric Psychiatry, 31, 309315.Google Scholar
Cornelis, E., Gorus, E., Beyer, I., Bautmans, I. and De Vriendt, P. (2017). Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: development of a new evaluation tool. PLoS Medicine, 14, Article no. e1002250.Google Scholar
de Rotrou, J. et al. (2012). DAD-6: a 6-Item version of the disability assessment for dementia scale which may differentiate Alzheimer's disease and mild cognitive impairment from controls. Dementia and Geriatric Cognitive Disorders, 33, 210218.Google Scholar
De Vriendt, P., Mets, T., Petrovic, M. and Gorus, E. (2015). Discriminative power of the advanced activities of daily living (a-ADL) tool in diagnosis of mild cognitive impairment in an older population. International Psychogeriatrics, 22, 119.Google Scholar
De Vriendt, P., Gorus, E., Cornelis, E., Bautmans, I., Petrovic, M. and Mets, T. (2013). The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment. The Journal of Nutrition, Health and Aging, 17, 6471.Google Scholar
DeLong, E. R., DeLong, D. and Clarke-Pearson, D. L. (1988). Comparing the areas under two or more correlated receiver operating characteristics curves: a nonparametric approach. Biometrics, 44, 837845.Google Scholar
Dubois, B., Padovani, A., Scheltens, P., Rossi, A. and Dell'Agnello, G. (2016). Timely diagnosis for Alzheimer's disease: a literature review on benefits and challenges. Journal of Alzheimer's Disease, 49, 617631.Google Scholar
Farias, S. T., Mungas, D. and Jagust, W. (2005). Degree of discrepancy between self and other-reported memory and everyday functioning by cognitive status: dementia, mild cognitive impairment and healthy elders. International Journal of Geriatric Psychiatry, 20, 827834.Google Scholar
Fauth, E. B., Schwartz, S., Tschanz, J., Ostbye, T., Corcoran, C. and Norton, M. C. (2013). Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms. International Journal of Geriatric Psychiatry, 28, 597606.Google Scholar
Fieo, R., Austin, E. J., Starr, J. M. and Deary, I. J. (2011). Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review. BMC Geriatrics, 11, 42.Google Scholar
Fisher, A. (1999). Assessment of Motor and Process Skills. Fort Collins, CO: Three Star Press.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gallagher, D. et al. (2010). Detecting prodromal Alzheimer's disease in mild neuropsychological, cognitive impairment: utility of the CAMCOG and other predictors. International Journal of Geriatric Psychiatry, 25, 12801287.Google Scholar
Giovannetti, T., Libon, D., Buxbaum, L. J. and Schwartz, M. F. (2002a). Naturalistic action impairments in dementia. Neuropsychologia, 40, 12201232.Google Scholar
Gold, D. A. (2012). An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment. Journal of Clinical and Experimental Neuropsychology, 34, 1134.Google Scholar
Hugo, J. and Ganguli, M. (2014). Dementia and cognitive impairment: epidemiology, diagnosis and treatment. Clinics in Geriatric Medicine, 30, 421442.Google Scholar
Hunsley, J. and Meyer, G. (2003). The incremental validity of psychological testing and assessment: conceptual, methodological, and statistical issues. Psychological Assessment, 15, 446455.Google Scholar
Jekel, K. et al. (2015). Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimer's Research & Therapy, 7, 17.Google Scholar
Jung, M. A., Kim, H., Kang, Y. J. and Kim, Y. J. (2013). Development of a modified naturalistic action test for Korean patients with impaired cognition. Annals of Rehabilitation Medicine, 37, 5765.Google Scholar
Katz, S. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA, 185, 914919.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.Google Scholar
Marshall, G. A., Amariglio, R., Sperling, R. A. and Rentz, D. M. (2012). Activities of daily living: where do they fit in the diagnosis of Alzheimer's disease? Neurodegenerative Disease Management, 2, 483491.Google Scholar
McKhann, G. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA working group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology, 34, 939944.Google Scholar
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7, 263269.Google Scholar
Nielsen, L. M., Kirkegaard, H., Ostergaard, L. H., Bovbjerg, K., Breinholt, K. and Maribo, T. (2016). Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department: implications for selection of clinical outcome measures. BMC Geriatrics, 16, 199.Google Scholar
Pedrosa, H. et al. (2010). Functional evaluation distinguishes MCI patients from healthy elderly people – the ADCS/MCI/ADL scale. Journal of Nutrition Health and Aging, 14, 703709.Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 240246.Google Scholar
Petersen, R. C., Caracciolo, B., Brayne, C., Gauthier, S., Jelic, V. and Fratiglioni, L. (2014). Mild cognitive impairment: a concept in evolution. Journal of Internal Medicine, 275 214228.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323329.Google Scholar
Puente, A. N., Terry, D. P., Faraco, C. C., Brown, L. C. and Miller, L. S. (2014). Functional impairment in mild cognitive impairment evidenced using performance-based measurement. Journal of Geriatric Psychiatry and Neurology, 27, 253258.Google Scholar
Reppermund, S. et al. (2016). Performance-based assessment of instrumental activities of daily living: validation of the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Journal of the American Medical Directors Association, 18, 117122.Google Scholar
Reuben, D. B., Laliberte, L., Hiris, J. and Mor, V. (1990). A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. Journal of the American Geriatrics Society, 38, 855861.Google Scholar
Rockwood, K. (2007). The measuring, meaning and importance of activities of daily living (ADLs) as an outcome. International Psychogeriatrics, 19, 467482.Google Scholar
Rodakowksi, J. et al. (2014). Can performance on daily activities discriminate between older adults with normal cognitive function and those with mild cognitive impairment? Journal of the American Geriatrics Society, 62, 13471352.Google Scholar
Roedersheimer, K. M., Pereira, G. F., Jones, C. W., Braz, V. A., Mangipudi, S. A. and Platts-Mills, T. F. (2016). Self-reported versus performance-based assessments of a simple mobility task among older adults in the emergency department. Annals of Emergency Medicine, 67, 151–6.Google Scholar
Rycroft, S. S., Giovanetti, T., Divers, R. and Hulswit, J. (2017). Sensitive performance-based assessment of everyday action in older and younger adults. Neuropsychology, Development, and Cognition Section B: Aging Neuropsychology and Cognition, 7, 118.Google Scholar
Sager, M. A., Dunham, N. C., Schwantes, A., Mecum, L., Halverson, K. and Harlowe, D. (1992). Measurement of activities of daily living in hospitalized elderly: a comparison of self-report and performance-based methods. Journal of the American Geriatric Society, 40, 457462.Google Scholar
Schmitter-Edgecombe, M., Parsey, C. and Cook, D. J. (2014). Cognitive correlates of functional abilities in individuals with mild cognitive impairment: comparison of questionnaire, direct observation and performance-based measures. The Clinical Neuropsychologist, 28, 726746.Google Scholar
Schwartz, M. F., Segal, M., Veramonti, T., Ferraro, M. and Buxbaum, L. J. (2002). The naturalistic action test: a standardised assessment for everyday action impairment. Neuropsychological Rehabilitation, 12, 311339.Google Scholar
Seelye, A. M., Schmitter-Edgecombe, M., Cook, D. J. and Crandall, A. (2013). Naturalistic assessment of everyday activities and prompting technologies in mild cognitive impairment. Journal of the International Neuropsychological Society, 19, 442452.Google Scholar
Sestito, N., Schmidt, K., Gallo, J. L., Giovannetti, T. and Libon, D. J. (2005). Using the Naturalistic Action Test (NAT) to assess everyday action in healthy older adults and patients with dementia. Journal of the International Neuropsychological Society, 11, 9091.Google Scholar
Sikkes, S. A. and Rotrou, J. D. (2014). A qualitative review of instrumental activities of daily living in dementia: what's cooking? Neurodegenerative Disease Management, 4, 393400.Google Scholar
Stewart, M. et al. (2011). Instrumental activities of daily living among community-dwelling older adults: discrepancies between self-report and performance are mediated by cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 33, 92100.Google Scholar
Suchy, Y., Kraybill, M. L. and Franchow, E. (2011). Instrumental activities of daily living among community-dwelling older adults: discrepancies between self-report and performance are mediated by cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 33, 92100.Google Scholar
Wadley, V. G., Okonkwo, O., Crowe, M., and Ross-Meadows, L. A. (2008). Mild cognitive impairment and everyday function: evidence of reduced speed in performing instrumental activities of daily living. American Journal of Geriatric Psychiatry, 16, 416424.Google Scholar
Wesson, J., Cemson, L., Brodaty, H. and Reppermund, S. (2016). Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: a systematic review and evaluation of measurement properties. Neuroscience and Biobehavioral Reviews, 68, 335360.Google Scholar
World Health Organization. (2001). International Classification of Functioning, Disability and Health (ICF). Geneva, Switzerland: World Health Organization.Google Scholar
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