Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-02T18:56:57.154Z Has data issue: false hasContentIssue false
  • English
  • Français

Performance-Based Everyday Functioning after Stroke: Relationship with IADL Questionnaire and Neurocognitive Performance

Published online by Cambridge University Press:  31 August 2011

Joseph R. Sadek ,
Nikki Stricker ,
John C. Adair  and
Kathleen Y. Haaland
Joseph R. Sadek*
Affiliation:
New Mexico VA Health Care System, Albuquerque, New Mexico Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico
Nikki Stricker
Affiliation:
Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Psychiatry, Boston University School of Medicine, Boston Massachusetts
John C. Adair
Affiliation:
New Mexico VA Health Care System, Albuquerque, New Mexico Department of Neurology, University of New Mexico, Albuquerque, New Mexico
Kathleen Y. Haaland
Affiliation:
New Mexico VA Health Care System, Albuquerque, New Mexico Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico Department of Neurology, University of New Mexico, Albuquerque, New Mexico
*
Correspondence and reprint requests to: Joseph R. Sadek, New Mexico VA Healthcare, Psychiatry, 1501 San Pedro Drive SE (116B), Albuquerque, NM 87108. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Neuropsychologists frequently are asked to comment on everyday functioning, but the research relies mostly on questionnaire-based assessment of daily functioning. While performance-based assessment of everyday functioning has many advantages over commonly used questionnaires, there are few empirically validated comprehensive performance-based measures. We present data here on a performance-based battery of daily living skills, the Functional Impact Assessment (FIA) in 47 unilateral stroke patients and 37 matched healthy controls. The FIA was validated by comparing it to performance on the self- and informant-report version of the Functional Activities Questionnaire (FAQ). We also examined the relationship between the FIA and cognitive functioning using the Neuropsychological Assessment Battery (NAB). The stroke group's performance on the FIA, FAQ (self and informant), and NAB (total and domain scores) was significantly (d′s ≥ .80) lower than the control group. The NAB total score and all domain scores were highly correlated with the FIA in the stroke group (r's > .7), and only one NAB domain score (visuospatial) was a unique predictor. This may be due to the fact that most of the NAB domains have a statistical problem of multicollinearity, which may explain why only the spatial domain was a unique predictor. While the informant FAQ was significantly correlated with FIA total score (r = .48, p < .01), the NAB total score was a significantly better predictor (r = .83, p < .001) than the informant FAQ. NAB total scaled score of less than 86 predicted impairment on the FIA with 92% sensitivity and 84% specificity. Our findings argue that the FIA is sensitive to deficits associated with stroke and is highly associated with all neuropsychological domains (attention, executive functions, language and spatial skills, and memory). (JINS, 2011, 17, 832–840)

Keywords

ADLNeuropsychologyPsychological testsCVASelf reportNeeds assessment
Type
Regular Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 5 , September 2011 , pp. 832 - 840
Copyright
Copyright © The International Neuropsychological Society 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, S.M., Weber, C.M., Todak, G., Polanco, C., Clouse, R., McElhiney, M., Marder, K. (1999). An observed performance test of medication management ability in HIV: Relation to neuropsychological status and medication outcomes. AIDS and Behavior, 3, 121–128.Google Scholar
Aubin, G., Stip, E., Golinas, I., Rainville, C., Chapparo, C. (2009). Daily activities, cognition and community functioning in persons with schizophrenia. Schizophrenia Research, 107, 313–318.Google Scholar
Barker-Collo, S., Feigin, V. (2006). The impact of neuropsychological deficits on functional stroke outcomes. Neuropsychology Review, 16, 53–64.CrossRefGoogle ScholarPubMed
Bates, E., Wilson, S.M., Saygin, A.P., Dick, F., Sereno, M.I., Knight, R.T., Dronkers, N.F. (2003). Voxel-based lesion-symptom mapping. Nature Neuroscience, 6, 448–450.Google Scholar
Bernspång, B., Fisher, A.G. (1995). Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process Skills. Archives of Physical Medicine and Rehabilitation, 76, 1144–1151.CrossRefGoogle ScholarPubMed
Bowerman, B.L., O’ Connell, R.T. (1990). Linear statistical models: An applied approach (2nd ed.). Belmont, CA: Duxbury.Google Scholar
Boyle, P.A., Cohen, R.A., Paul, R., Moser, D., Gordon, N. (2002). Cognitive and motor impairments predict functional declines in patients with vascular dementia. International Journal of Geriatric Psychiatry, 17, 164–169.Google Scholar
Boyle, P.A., Malloy, P.F., Salloway, S., Cahn-Weiner, D.A., Cohen, R., Cummings, J.L. (2003). Executive dysfunction and apathy predict functional impairment in Alzheimer disease. American Journal of Geriatric Psychiatry, 11, 214–221.CrossRefGoogle ScholarPubMed
Brown, L.B., Stern, R.A., Cahn-Weiner, D.A., Rogers, B., Messer, M.A., Lannon, M.C., Ott, B.R. (2005). Driving scenes test of the Neuropsychological Assessment Battery (NAB) and on-road driving performance in aging and very mild dementia. Archives of Clinical Neuropsychology, 20, 209–215.CrossRefGoogle ScholarPubMed
Buxbaum, L.J., Schwartz, M.F., Montgomery, M.W. (1998). Ideational apraxia and naturalistic action. Cognitive Neuropsychology, 15, 617–643.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Jacob Cohen Publishers.Google Scholar
Corbett, F., Jefferies, E., Lambon Ralph, M.A. (2009). Exploring multimodal semantic control impairments in semantic aphasia: Evidence from naturalistic object use. Neuropsychologia, 47, 2721–2731.Google Scholar
Cullum, C.M., Weiner, M.F., Saine, K.C. (2009). Texas functional living scale examiner's manual. San Antonio, TX: Pearson.Google Scholar
Dassel, K.B., Schmitt, F.A. (2008). The impact of caregiver executive skills on reports of patient functioning. The Gerontologist, 48, 781–792.CrossRefGoogle ScholarPubMed
DeArmond, S.J., Fusco, M.M., Dewey, M.M. (1989). Structure of the human brain: A photographic atlas (3rd ed.). New York: Oxford University Press.Google Scholar
Demers, L., Oremus, M., Perrault, A., Champoux, N., Wolfson, C. (2000). Review of outcome measurement instruments in Alzheimer's disease drug trials: Psychometric properties of functional and quality of life scales. Journal of Geriatric Psychiatry and Neurology, 13, 170–180.Google Scholar
Diehl, M., Marsiske, M., Horgas, A.L., Rosenberg, A., Saczynski, J.S., Willis, S.L. (2005). The revised observed tasks of daily living: A performance-based assessment of everyday problem solving in older adults. Journal of Applied Gerontology, 24, 211–230.CrossRefGoogle ScholarPubMed
Drozdick, L.W., Cullum, C.M. (2010). Expanding the ecological validity of WAIS-IV and WMS-IV with the Texas Functional Living Scale. Assessment, 18, 141–155.CrossRefGoogle Scholar
Farias, S.T., Cahn-Weiner, D.A., Harvey, D.J., Reed, B.R., Mungas, D., Kramer, J.H., Chui, H. (2009). Longitudinal changes in memory and executive functioning are associated with longitudinal change in instrumental activities of daily living in older Adults. Clinical Neuropsychologist, 23, 446–461.CrossRefGoogle Scholar
Festa, J.R., Lazar, R.M., Marshall, R.S. (2008). Ischemic stroke and aphasic disorders. In J. Morgan & J. Ricker (Eds.), Textbook of Clinical Neuropsychology (pp. 363–383). New York: Psychology Press.Google Scholar
Frey, R.T., Woods, D.L., Knight, R.T., Scabini, D., Clayworth, C. (1987). Defining functional areas with averaged CT scans. Society of Neuroscience Abstracts, 13, 1266.Google Scholar
Grewal, R., Cote, J.A., Baumgartner, H. (2004). Multicollinearity and measurement error in structural equation models: implications for theory testing. Marketing Science, 23, 519–529.CrossRefGoogle Scholar
Haaland, K.Y., Prestopnik, J.L., Knight, R.T., Lee, R.R. (2004). Hemispheric asymmetries for kinematic and positional aspects of reaching. Brain, 127, 1145–1158.CrossRefGoogle ScholarPubMed
Heaton, R.K., Marcotte, T.D., Mindt, M.R., Sadek, J., Moore, D.J., Bentley, H. … The HNRC Group. (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10, 317–331.CrossRefGoogle ScholarPubMed
Heaton, R., Miller, S., Taylor, M., Grant, I. (2004). Revised comprehensive norms for an expanded Halstead-Reitan battery: Demographically adjusted neuropsychological norms for African American and Caucasian adults. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Jette, A.M., Davies, A.R., Cleary, P.D., Calkins, D.R., Rubenstein, L.V., Fink, A., Delbanco, T.L. (1986). The functional status questionnaire: Reliability and validity when used in primary care. Journal of General Internal Medicine, 1, 143–149.Google Scholar
Kangas, M., Tate, R.L. (2006). The significance of clumsy gestures in apraxia following a left hemisphere stroke. Neuropsychological Rehabilitation, 16, 38–65.CrossRefGoogle ScholarPubMed
Karver, C., Teshiba, T.M., Haaland, K.Y., Adair, J.C., Sadek, J.R. (2008). Performance-based assessment: Correlation with neuropsychological functioning in a dementia sample. Journal of the International Neuropsychological Society, 14, 252.Google Scholar
Knight, R.T., Scabini, D., Woods, D.L., Clayworth, C. (1988). The effects of lesions of superior temporal gyrus and inferior parietal lobe on temporal and vertex components of the human AEP. Electroencephalography and Clinical Neurophysiology, 70, 499–509.Google Scholar
Lawton, M.P., Brody, E.M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Lezak, M.D., Howieson, D.B., Loring, D.W. (2004). Neuropsychological assessment. New York, NY: Oxford University Press, Inc.Google Scholar
Loewenstein, D.A., Bates, D.C. (1992). Manual for administration and scoring the direct assessment of functional status scale for older adults (DAFS). Miami Beach, FL: Mount Sinai Medical Center.Google Scholar
Loewenstein, D.A., Amigo, E., Duara, R., Guterman, A., Hurwitz, D., Berkowitz, N., Eisdorfer, C. (1989). A new scale for the assessment of functional status in Alzheimer's disease and related disorders. Journal of Gerontology, 44, 114–121.CrossRefGoogle ScholarPubMed
Loewenstein, D.A., Rubert, M.P., Duara, R. (1995). Neuropsychological test performance and prediction of functional capacities among Spanish-speaking and English-speaking patients with dementia. Archives of Clinical Neuropsychology, 10, 75–88.CrossRefGoogle ScholarPubMed
Mackin, R.S., Arean, P.A. (2009). Impaired financial capacity in late life depression is associated with cognitive performance on measures of executive functioning and attention. Journal of the International Neuropsychological Society, 15, 793–798.CrossRefGoogle ScholarPubMed
Marcotte, T.D., Grant, I. (2010). Neuropsychology of everyday functioning. New York, NY: Guilford Press.Google Scholar
Mitrushina, M., Boone, K.B., Razani, J., D'Elia, L. (2005). Handbook of normative data for neuropsychological assessment (2nd ed.). New York, NY: Oxford University Press.Google Scholar
Pfeffer, R.I., Kurosaki, T.T., Harrah, C.H., Chance, J.M., Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323–329.CrossRefGoogle ScholarPubMed
Ready, R.E., Ott, B.R., Grace, J. (2004). Validity of informant reports about AD and MCI patients’ memory. Alzheimer Disease and Associated Disorders, 18, 11–16.CrossRefGoogle ScholarPubMed
Rinehart, J.K., Singleton, R.D., Adair, J.C., Sadek, J.R., Haaland, K.Y. (2009). Arm use after left or right hemiparesis is influenced by hand preference. Stroke, 40, 545–550.CrossRefGoogle ScholarPubMed
Sadek, J.R., Haaland, K.Y., Adair, J.C., Teshiba, T.M., Karver, C. (2010). MMSE may predict IADLs better than a neuropsychological battery. Poster presentation at the American Psychological Association Convention, August 12–14, San Diego, CA.Google Scholar
Sbordone, R.J., Long, C.J. (1996). Ecological validity of neuropsychological testing. Delray Beach, FL England: Gr Press/St Lucie Press, Inc.Google Scholar
Schaefer, S.Y., Haaland, K.Y., Sainburg, R.L. (2007). Ipsilesional motor deficits following stroke reflect hemispheric specializations for movement control. Brain, 130, 2146–2158.CrossRefGoogle ScholarPubMed
Schmitter-Edgecombe, M., Woo, E., Greeley, D.R. (2009). Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. Neuropsychology, 23, 168–177.CrossRefGoogle ScholarPubMed
Schwartz, M.F., Buxbaum, L.J., Montgomery, M.W., Fitzpatrick-DeSalme, E., Hart, T., Ferraro, M., Coslett, H.B. (1999). Naturalistic action production following right hemisphere stroke. Neuropsychologia, 37, 51–66.Google Scholar
Sherod, M.G., Griffith, H.R., Copeland, J., Belue, K., Krzywanski, S., Zamrini, E.Y., Marson, D.C. (2009). Neurocognitive predictors of financial capacity across the dementia spectrum: Normal aging, mild cognitive impairment, and Alzheimer's disease. Journal of the International Neuropsychological Society, 15, 258–267.CrossRefGoogle ScholarPubMed
Shih, M., Rogers, J., Holm, M. (2009). Differences in daily task performance between left versus right hemispheric stroke survivors. Archives of Physical Medicine and Rehabilitation, 90, p. e16.CrossRefGoogle Scholar
Sikkes, S., de Lange-de Klerk, E., Pijnenburg, Y., Scheltens, P., Uitdehaag, B. (2008). A systematic review of instrumental activities of daily living scales in dementia: Room for improvement. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 7–12.Google Scholar
Snow, A.L., Norris, M.P., Doody, R., Molinari, V.A., Orengo, C.A., Kunik, M.E. (2004). Dementia deficits scale: Rating self-awareness of deficits. Alzheimer Disease and Associated Disorders, 18, 22–31.Google Scholar
Stern, R.A., White, T. (2003). Neuropsychological Assessment Battery: Administration, scoring, and interpretation manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Strauss, E., Sherman, E.M.S., Spreen, O. (2002). A compendium of neuropsychological tests: Administration, norms, and commentary (3rd ed.). New York: Oxford University Press.Google Scholar
Stricker, N., Tyber, J., Sadek, J., Haaland, K.Y. (2010). Utility of the neuropsychological assessment battery in detecting cognitive impairment after unilateral stroke. Journal of the International Neuropsychological Society, 16, 813–821.CrossRefGoogle ScholarPubMed
Su, C.Y., Chen, C.C., Wuang, Y.P., Lin, Y.H., Wu, Y.Y. (2008). Neuropsychological predictors of everyday functioning in adults with intellectual disabilities. Journal of Intellectual Disability Research, 52, 18–28.Google Scholar
Temple, R.O., Zgaljardic, D.J., Abreu, B.C., Seale, G.S., Ostir, G.V., Ottenbacher, K.J. (2009). Ecological validity of the neuropsychological assessment battery screening module in post-acute brain injury rehabilitation. Brain Injury, 23, 45–50.Google Scholar
Teshiba, T.M., Haaland, K.Y., Adair, J.C., Sadek, J.R. (2008). Performance-based functional assessment: Correlation with self- and informant-report in a dementia sample. Journal of the International Neuropsychological Society, 14, 260.Google Scholar
Wechsler, D. (2008). Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) (4th ed.). San Antonio, TX: Pearson.Google Scholar
Wechsler, D. (2009). Wechsler Memory Scale—Fourth Edition (WMS-IV) (4th ed.). San Antonio, TX: Pearson.Google Scholar