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Impact of familiar and unfamiliar settings on cooking task assessments in frail older adults with poor and preserved executive functions

Published online by Cambridge University Press:  12 December 2011

Véronique Provencher*
Affiliation:
Research Center, Institut universitaire de gériatrie de Montréal, School of Rehabilitation, Université de Montréal, Montréal, Canada
Louise Demers
Affiliation:
Research Center, Institut universitaire de gériatrie de Montréal, School of Rehabilitation, Université de Montréal, Montréal, Canada
Lise Gagnon
Affiliation:
Research Center on Aging, Sherbrooke Geriatric University Institute, Department of Psychology, Université de Sherbrooke, Sherbrooke, Canada
Isabelle Gélinas
Affiliation:
School of Physical and Occupational Therapy, McGill University, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
*
Correspondence should be addressed to: Véronique Provencher, Research Center, Institut universitaire de gériatrie de Montréal, 4565 Queen Mary, Montreal, Quebec, CanadaH3W 1W5. Phone: +1-514-340-3540 ext. 4004; Fax: +1-514-340-3548. Email: [email protected].
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Abstract

Background: Hospitalized frail older patients are usually assessed for their ability to perform some daily living activities in a clinical setting prior to discharge. However, assessments that take place in this unfamiliar environment might not be as representative of their functional performance as assessments at home. This may be related to a decline in some cognitive components, such as executive functions (EF), which enable one to cope with new environments. This study thus aims to compare cooking task performance in familiar and unfamiliar settings in a population of frail older adults with poor and preserved EF.

Methods: Thirty-seven frail older adults were assigned to one of two groups: poor EF or preserved EF. Participants performed two cooking tasks in familiar and unfamiliar settings, using a counterbalanced design. Their performance was assessed with a reliable tool based on observation of motor and process skills (Assessment of Motor and Process Skills).

Results: Thirty-three participants were retained for analysis. They demonstrated significantly better motor skills (F = 5.536; p = 0.025) and process skills (F = 8.149; p = 0.008) in the familiar setting. The difference between settings was particularly marked for process skills in participants with poor EF (F = 16.920; p < 0.001).

Conclusions: This study suggests that a home setting may be preferable for a more accurate assessment of cooking task performance in frail older adults, especially those with poor EF. These findings highlight the risk of underestimating frail older adults’ performance when assessed in an unfamiliar setting (e.g. hospital), which could lead to inefficient allocation of home care services.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Aiken, L., Clarke, S., Sloane, D. and International Hospital Outcomes Research Consortium (2002). Hospital staffing, organization, and quality of care: cross-national findings. International Journal of Quality Health Care, 14, 513.CrossRefGoogle ScholarPubMed
AMPS Project International (2011). 30 January 2011, retrieved from http://www.ampsintl.com/AMPS/index.php.Google Scholar
Binetti, G., Magni, E., Padovani, A., Cappa, S. F., Bianchetti, A. and Trabucchi, M. (1996). Executive dysfunction in early Alzheimer's disease. Journal of Neurology, Neurosurgery & Psychiatry, 60, 9193.CrossRefGoogle ScholarPubMed
Coyette, F. and Van der Linden, M. (1993). Tour de Londres (adaptation de Shallice T, 1982). Bruxelles, Belgium: Cliniques universitaires St-Luc.Google Scholar
Craik, F. I. and Bialystok, E. (2006). Planning and task management in older adults: cooking breakfast. Memory & Cognition, 34, 12361249.CrossRefGoogle ScholarPubMed
Darragh, A., Sample, P. L. and Fisher, A. G. (1998). Environment effect of functional task performance in adults with acquired brain injuries: use of the assessment of motor and process skills. Archives of Physical Medicine and Rehabilitation, 79, 418423.CrossRefGoogle ScholarPubMed
Di Fabio, R. P., Zampieri, C., Henke, J., Olson, K., Rickheim, D. and Russell, M. (2005). Influence of elderly executive cognitive function on attention in the lower visual field during step initiation. Gerontology, 51, 94107. doi:GER2005051002094 [pii]10.1159/000082194.CrossRefGoogle ScholarPubMed
Ferrucci, L., Guralnik, J. M., Studenski, S., Fried, L. P., Cutler, G. B. and Walston, J. D. (2004). Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. Journal of the American Geriatrics Society, 52, 625634. doi:10.1111/j.1532-5415.2004.52174. xJGS52174 [pii].CrossRefGoogle ScholarPubMed
Fisher, A. (2003). Assessment of Motor and Process Skills. Colorado State, CO: Three Star Press.Google Scholar
Fried, L. et al. (2001). Frailty in older adults: evidence for a phenotype. Journal of Gerontology: Medical Sciences, 56, M146M156.Google ScholarPubMed
Fried, L. and Watson, J. (1998). Frailty and failure to thrive. In Hazzard, W. R., Blass, J. P., Ettinger, W. H., Halter, J. B. and Ouslander, J. (eds.), Principles of Geriatric Medicine and Gerontology, 4th edn (pp. 13871402). New York: McGraw Hill.Google Scholar
Hagedorn, R. (1995). Environmental analysis and adaptation. In Law, M. (ed.), Occupational Therapy: Perspectives and Processes (pp. 239258). New York: Churchill Livingstone.Google Scholar
Hoppes, S., Davis, L. A. and Thompson, D. (2003). Environmental effects on the assessment of people with dementia: a pilot study. American Journal of Occupational Therapy, 57, 396402.CrossRefGoogle ScholarPubMed
Isingrini, M. (2004). Fonctions exécutives, mémoire et métamémoire dans le vieillissement normal. In Meulemans, T., Collette, F. and Van der Linden, M. (eds.), Neuropsychologie des fonctions exécutives (pp. 79108). Marseille, France: SOLAL.Google Scholar
Johnson, J. K., Lui, L. Y. and Yaffe, K. (2007). Executive function, more than global cognition, predicts functional decline and mortality in elderly women. Journal of Gerontology: Medical Sciences, 62, 11341141. doi:62/10/1134 [pii].Google ScholarPubMed
Kliegel, M., Martin, M., McDaniel, M. and Phillips, L. (2007). Adult age differences in errand planning: the role of task familiarity and cognitive resources. Experimental & Aging Research, 33, 145161.CrossRefGoogle ScholarPubMed
Lezak, M. D., Howieson, D. B., Loring, D. W., Hannay, J. and Fisher, J. (2004). Neuropsychological Assessment. 4th edition. New York: Oxford University Press.Google Scholar
Lim, H. J., Hoffmann, R. and Brasel, K. (2007). Factors influencing discharge location after hospitalization resulting from a traumatic fall among older persons. Journal of Traumatology, 63, 902907. doi:10.1097/01.ta.0000240110.14909.7100005373-200710000-00028 [pii].Google ScholarPubMed
Lundberg, C. and Hakamies-Blomqvist, L. (2003). Driving tests with older patients: effect of unfamiliar versus familiar vehicle. Transportation Research, F6, 163173.Google Scholar
Mountain, G. and Pighills, A. (2002). Pre-discharge home visits with older people: time to review practice. Health and Social Care in the Community, 11, 146154.CrossRefGoogle Scholar
Nygård, L., Bernspang, B., Fisher, A. G. and Winblad, B. (1994). Comparing motor and process ability of suspected persons with dementia in home and clinic settings. American Journal of Occupational Therapy, 48, 689696.CrossRefGoogle ScholarPubMed
Park, S., Fisher, A. and Velozo, C. (1994). Using the assessment of motor and process skills to compare occupational performance between clinic and home settings. American Journal of Occupational Therapy, 48, 697709.CrossRefGoogle ScholarPubMed
Patrick, L., Gaskovski, P. and Rexroth, D. (2002). Cumulative illness and neuropsychological decline in hospitalized geriatric patients. Clinical Neuropsychologist, 16, 145156.CrossRefGoogle ScholarPubMed
Raina, K. D., Rogers, J. C. and Holm, M. B. (2007). Influence of the environment on activity performance in older women with heart failure. Disability and Rehabilitation, 29, 545557.CrossRefGoogle ScholarPubMed
Rogers, J. et al. (2003). Concordance of four methods of disability assessment using performance in the home as the criterion method. Arthritis and Rheumatism, 49, 640647.CrossRefGoogle ScholarPubMed
Strauss, E. and Spreen, O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. New York: Oxford University Press.Google Scholar
Van der Linden, M., Meulemans, T., Seron, X., Coyette, F., Andrès, P. and Prairial, C. (2000). L'évaluation des fonctions exécutives. In Seron, X. and Van der Linden, M. (eds.), Traité de neuropsychologie clinique, vol. 1. Marseille, France: SOLAL.Google Scholar
Van der Linden, M. (2004). L'épreuve de rappel libre/rappel indicé à 16 items (RL-RI-16). In Van der Linden, M. (ed.). L'évaluation des troubles de la mémoire (pp. 2547), Marseille, France: SOLAL.Google Scholar
Wells, J. L., Seabrook, J. A., Stolee, P., Borrie, M. J. and Knoefel, F. (2003). State of the art in geriatric rehabilitation. Part I: review of frailty and comprehensive geriatric assessment. Archives of Physical Medicine and Rehabilitation, 84, 890897. doi:S0003999302049298 [pii].CrossRefGoogle ScholarPubMed
West, S. K., Rubin, G. S., Munoz, B., Abraham, D., Fried, L. P. and the Salisbury Eye Evaluation Project Team (1997). Assessing functional status: correlation between performance on tasks conducted in a clinic setting and performance on the same task conducted at home. Journal of Gerontology: Medical Sciences, 52A, M209M217.Google Scholar