Assessment of the Financial Capacity in the Context of Normal and Pathological Cognitive Aging. Preliminary Analysis of the Portuguese Version of the Numerical Activities of Daily- Living- Financial (NADL-F)

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.

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Validation of the Portuguese Version of the Postoperative Quality Recovery Scale (PostopQRS)

Acta Médica Portuguesa ◽

10.20344/amp.9451 ◽

2018 ◽

Vol 31 (10) ◽

pp. 551

Author(s):

André Biscaia ◽

Pedro Amorim ◽

Simão Esteves ◽

Filipa Lagarto ◽

Blandina Gomes ◽

...

Keyword(s):

Muscle Strength ◽

Construct Validity ◽

Activities Of Daily Living ◽

Daily Living ◽

Elective Surgery ◽

Portuguese Version ◽

Quality Of Recovery ◽

Postoperative Quality ◽

Over Time

Introduction: The Postoperative Quality Recovery Scale is a brief instrument of six domains designed to assess quality of recovery from early to long term after surgery. This study aims to validate the Portuguese version of the Postoperative Quality Recovery Scale.Material and Methods: In this observational study 101 adult patients undergoing elective surgery completed the Postoperative Quality Recovery Scale at 15 minutes and 40 minutes, one and three days after surgery. Three constructs were assessed for validity: increased recovery over time; effect of gender and recovery association with muscle strength. Reliability, responsiveness, feasibility and acceptability were also assessed.Results: Construct validity was shown by increased recovery over time; worse recovery for female patients in emotive, nociceptive, activities of daily living and overall recovery; improved muscle strength in recovered patients. Internal consistency for activities of daily living was acceptable at all-time points (Cronbach’s α value of 0.772 or higher), indicating scale reliability. The scale was able to detect differences in postoperative quality of recovery between the neuromuscular blockade reversal agents, neostigmine and sugammadex, indicating scale responsiveness. The time to conduct the Portuguese version at baseline was 95 - 581 seconds (median 319 seconds) and it was reduced with subsequent assessments. The proportion of patients completing all scale items was 87%, 75%, 65% and 94% for the four time periods evaluated, indicating scale feasibility and acceptability.Discussion: This study shows that the Portuguese version of the Postoperative Quality Recovery Scale, demonstrates construct validity, reliability, responsiveness, feasibility and acceptability.Conclusions: This study allowed validation of the Portuguese version of the Postoperative Quality Recovery Scale.

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A useful development in measuring activities of daily living

International Psychogeriatrics ◽

10.1017/s1041610215000964 ◽

2015 ◽

Vol 27 (9) ◽

pp. 1417-1417

Author(s):

David Ames

Keyword(s):

Activities Of Daily Living ◽

Cognitive Aging ◽

Daily Living ◽

Editorial Team ◽

Amyloid Pet ◽

Prodromal Ad ◽

Prodromal Alzheimer’S Disease ◽

1960S And 1970S ◽

The 1960S ◽

User Friendly

Standard activities of daily living (ADL) scales developed in the 1960s and 1970s do not capture the subtle impairments seen in individuals with progressive mild cognitive impairment (MCI), which in many cases is due to prodromal Alzheimer's disease (AD). Given the promise of treatments now in development to modify the underlying AD process, early detection of MCI may become very important in future. De Vriendt and colleagues, whose paper has been chosen by the editorial team of International Psychogeriatrics, to be paper of the month in this issue, are to be congratulated for developing and validating the advanced ADL tool with the aim of providing a useful ADL measure to distinguish normal from pathological cognitive aging. They have assessed a large sample (150 people with AD, MCI and healthy controls) and report acceptable parameters for discrimination of these three groups using the instrument they have developed. The next step will be to try it out in a variety of clinical populations, settings, and cultures and perhaps to see how well it stacks up against other methods of detecting preclinical and prodromal AD (e.g. amyloid PET scans or lumbar punctures). The publication of this very good paper will allow other teams around the world to start using this user-friendly instrument and I await the outcome of further work on it with great interest.

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Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population

International Psychogeriatrics ◽

10.1017/s1041610215000563 ◽

2015 ◽

Vol 27 (9) ◽

pp. 1419-1427 ◽

Cited By ~ 15

Author(s):

P. De Vriendt ◽

T. Mets ◽

M. Petrovic ◽

E. Gorus

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Activities Of Daily Living ◽

Clinical Evaluation ◽

Predictive Value ◽

Cognitive Aging ◽

Daily Living ◽

Functional Decline ◽

Community Dwelling ◽

Discriminative Power

ABSTRACTBackground:Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments in the absence of manifest functional decline. Mild changes in activities of daily living (ADL) can be present and probably predict conversion to dementia. A new advanced (a)-ADL tool was developed, evaluating high-level activities and, taking each participant as their own reference, distinguishing a global Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), based on the number of activities performed and the severity and causes of the functional problem. This study evaluates the discriminative validity of the a-ADL in MCI.Method:Based upon clinical evaluation and a set of global, cognitive, mood, and functional assessments, 150 community-dwelling participants (average age 80.3 years (SD 5; 66–91)) were included and diagnosed as (1) cognitively healthy participants (n = 50); (2) patients with a-MCI (n = 48), or (3) mild to moderate AD (n = 52). The a-ADL tool was not a part of the clinical evaluation.Results:The a-ADL-DI and the a-ADL-CDI showed a sensitivity and specificity ranging from 70% to 94.2%, Positive Predictive Value ranging from 70% till 93.8%, and Negative Predictive Value from 64.4% and 93.8%, an area under the curve (AUC) ranging from 0.791 to 0.960. Functional decline related to physical deficits, as assessed by the a-ADL-PDI, did not discriminate between the different groups.Conclusion:The a-ADL tool has a good ability to distinguish normal and pathological cognitive aging. Its discriminative power for underlying causes of limitations may be an advantage.

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