A-61 Predictors of Subjective and Objective Everyday Functioning in Middle-Aged and Older Adults with HIV

2021 ◽  
Vol 36 (6) ◽  
pp. 1103-1103
Author(s):  
Alexandra E Jacob ◽  
Michael Crowe ◽  
Pariya L Fazeli ◽  
David E Vance
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Processing Speed ◽  
Daily Living ◽  
Self Report ◽  
Everyday Functioning ◽  
Actual Performance ◽  
Factors Associated ◽  
Instrumental Activities

Abstract Objective Older adults with HIV are at increased risk for difficulties with instrumental activities of daily living (IADLs). Awareness of their functional capacity has emerged as an important area for research, but it is not well studied in PWH. The purpose of this study is: (1) to identify factors associated with subjective and objective IADL difficulty in PWH and (2) to identify factors associated with under- or over-reporting of IADL difficulties. Methods This cross-sectional study included 261 adults with HIV. Participants completed a neuropsychological battery, self-report and performance-based measures of IADLs. Self-report measures included the Patient’s Assessment of Own Functioning Inventory (PAOFI) and the Lawton and Brody IADL Questionnaire. The Timed Instrumental Activities of Daily Living (TIADL) task was used as an objective measure. Hierarchical multiple regressions were performed to identify factors associated with subjective and objective assessment of everyday functioning as well as factors associated with discrepancy between self-report and actual performance of IADLS. Results On the PAOFI, higher depression (p = 0.001), lower conscientiousness (p > 0.001), and better processing speed (p = 0.017) predicted worse functioning. On the Lawton and Brody, higher depression (p = 0.049) predicted of worse functioning. On the TIADL, older age (p = 0.1), lower WRAT-4 score (p > 0.001), worse processing speed (p > 0.001), and worse motor function (p = 0.1) were associated with worse performance. Processing speed predicted discrepancy between subjective and objective performance of IADLs (p = 0.1). Conclusions Several demographic, cognitive, and personality variables are associated with worse subjective and objective everyday functioning, as well as an individual’s ability to accurately self-appraise their functional capacity.

ASSESSMENT OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE USING THE VIRTUAL REALITY FUNCTIONAL CAPACITY ASSESSMENT TOOL (VRFCAT)

2018 ◽  
pp. 1-9
Author(s):  
A.S. Atkins1 ◽  
A. Khan ◽  
D. Ulshen ◽  
A. Vaughan ◽  
D. Balentin ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Functional Capacity ◽  
Daily Living ◽  
Assessment Tool ◽  
Subjective Cognitive Decline ◽  
Capacity Assessment ◽  
Instrumental Activities

Background: Continuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest. Objectives: The present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline. Design: Cross-sectional validation study. Setting: All participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA. Participants: Participants included 245 healthy younger adults ages 20-54 (131 female), 247 healthy older adults ages 55-91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56-97 (45 female). Measures: Virtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project – Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living – Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment – Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B. Results: Participants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). Conclusions: Findings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.

Exploratory Review: Self-Report IADL Assessments in the age of Internet-Connected Assistive Devices

2020 ◽  
pp. 153944922094000
Author(s):  
Abbas H. Quamar ◽  
Mark R. Schmeler ◽  
Diane M. Collins ◽  
Richard M. Schein
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
People With Disabilities ◽  
Assistive Devices ◽  
Self Report ◽  
Inclusion Criteria ◽  
Everyday Functioning ◽  
Clinical Applicability ◽  
Instrumental Activities

Internet-Connected Assistive Devices (iCAD), like accessible smartphones, tablets, computers, and apps, have become an integral part of everyday functioning for people with disabilities (PWD). The objective of this article was to identify self-report assessments having the relevance and clinical applicability for assessing satisfaction with performing Instrumental Activities of Daily Living (IADL) for PWD using iCAD. An exploratory review was conducted to identify self-report assessments that were appropriate, practical, clinically fit, and psychometrically acceptable, for assessing satisfaction with performing IADLs for PWD using iCAD. Thirty-two IADL assessments were identified, of which six met inclusion criteria. Four of six assessments did not specifically address iCAD usage, while two assessments had limited relevance and clinical applicability, for assessing satisfaction with performing IADLs for PWD using iCAD. This review establishes the growing need for a self-report IADL assessment that has been specifically designed and validated for assessing satisfaction with performing IADLs for PWD using iCAD

The relationship between neuropsychological measures and the Timed Instrumental Activities of Daily Living task in multiple sclerosis

2007 ◽  
Vol 13 (5) ◽  
pp. 636-644 ◽  
Author(s):  
Y. Goverover ◽  
HM Genova ◽  
FG Hillary ◽  
J. DeLuca
Keyword(s):  
Multiple Sclerosis ◽  
Activities Of Daily Living ◽  
Processing Speed ◽  
Test Performance ◽  
Daily Living ◽  
Functional Independence ◽  
Everyday Functioning ◽  
Neuropsychological Measures ◽  
Instrumental Activities ◽  
The Relationship

Multiple sclerosis (MS) can result in cognitive deficits and a loss of functional independence. To date, little research has linked the observed cognitive and behavioral deficits in MS, especially those in the processing speed domain, to performance on tasks of everyday functioning. The present study examined the relationship between neuropsychological test performance and performance on the Timed Instrumental Activities of Daily Living task (TIADL) in individuals with MS, and in healthy controls (HCs). The TIADL is a functional measure, which assesses both accuracy and speed in one's performance of everyday activities. The MS group performed significantly worse on the TIADL relative to the HC group. Additionally, TIADL scores of individuals with MS were significantly correlated with neuropsychological measures of processing speed. TIADL scores were not, however, correlated with neuropsychological measures of verbal episodic memory or working memory. These results indicate that the impairments in processing speed may contribute to impairments in activities of everyday living in persons with MS. Multiple Sclerosis 2007; 13: 636-644. http://msj.sagepub.com

scholarly journals A web-based dynamic Nomogram for predicting instrumental activities of daily living disability in older adults: a nationally representative survey in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Zhang ◽  
Huijie Cui ◽  
Qiuzhi Chen ◽  
Yan Li ◽  
Chunxia Yang ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Validation Cohort ◽  
Self Report ◽  
Web Based ◽  
Training Cohort ◽  
Targeted Interventions ◽  
Instrumental Activities ◽  
Iadl Disability

Abstract Background Instrumental Activities of Daily Living (IADL) disability is a common health burden in aging populations. The identification of high-risk individuals is essential for timely targeted interventions. Although predictors for IADL disability have been well described, studies constructing prediction tools for IADL disability among older adults were not adequately explored. Our study aims to develop and validate a web-based dynamic nomogram for individualized IADL disability prediction in older adults. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We included 4791 respondents aged 60 years and over, without IADL disability at baseline in the 2011 to 2013 cohort (training cohort) and 371 respondents in the 2013 to 2015 cohort (validation cohort). Here, we defined IADL disability as needing any help in any items of the Lawton and Brody’s scale. A web-based dynamic nomogram was built based on a logistic regression model in the training cohort. We validated the nomogram internally with 1000 bootstrap resamples and externally in the validation cohort. The discrimination and calibration ability of the nomogram was assessed using the concordance index (C-index) and calibration plots, respectively. Results The nomogram incorporated ten predictors, including age, education level, social activity frequency, drinking frequency, smoking frequency, comorbidity condition, self-report health condition, gait speed, cognitive function, and depressive symptoms. The C-index values in the training and validation cohort were 0.715 (bootstrap-corrected C-index = 0.702) and 0.737, respectively. The internal and external calibration plots for predictions of IADL disability were in excellent agreement. An online web server was built (https://lilizhang.shinyapps.io/DynNomapp/) to facilitate the use of the nomogram. Conclusions We developed a dynamic nomogram to evaluate the risk of IADL disability precisely and expediently. The application of this nomogram would be helpful for health care physicians in decision-making.

scholarly journals Associations Between Self- and Informant-Reported Abilities of Instrumental Activities of Daily Living and Cognitive Functions in Older Adults With Mild Cognitive Impairment

2020 ◽  
Author(s):  
Xin Zhao ◽  
Wenjia Liang ◽  
Joseph H R Maes
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Daily Living ◽  
Instrumental Activities ◽  
Cognitive Processing Speed

Abstract Objective Older adults (OAs) with mild cognitive impairment (MCI) show disabilities in instrumental activities of daily living (IADLs), which have been linked to compromised cognitive functioning. However, it is unclear which cognitive functions are primarily involved. The present study sought to identify the cognitive function(s) most strongly associated with the IADL limitations in MCI. Method OAs with MCI (N = 120) completed cognitive tasks measuring general cognitive processing speed, working memory (WM) maintenance and updating, inhibition, and shifting ability. IADL abilities were assessed through both self- and informant reports. Results Self-reported IADL abilities were positively associated with both cognitive processing speed and WM updating capacity. Informant-reported IADL abilities were also positively associated with processing speed and WM updating, in addition to cognitive shifting ability. Conclusion Both general processing speed and WM updating capacity were consistently predictive of IADL abilities. These results might inform the design of training programs aimed at maintaining or improving functional independence in individuals with MCI to focus more on these cognitive functions. However, the strength of the association between specific cognitive functions and IADL abilities in OAs with MCI depends on the source of the information about the IADL abilities, which highlights the need for gathering data from both the examinee and informants.

Naturally Occurring Expressive Suppression is Associated with Lapses in Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

2019 ◽  
Vol 25 (7) ◽  
pp. 718-728 ◽  
Author(s):  
Yana Suchy ◽  
Madison A. Niermeyer ◽  
Emilie I. Franchow ◽  
Rosemary E. Ziemnik
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Independence ◽  
Community Dwelling ◽  
Self Report ◽  
Expressive Suppression ◽  
Instrumental Activities ◽  
Lower Accuracy ◽  
Community Dwelling Older Adults

AbstractObjectives: Expressive suppression (i.e., effortful regulation of overt affect) has a deleterious impact on executive functioning (EF). This relationship has potential ramifications for daily functioning, especially among older adults, because a close relationship exists between EF and functional independence. However, past research has not directly examined whether expressive suppression impacts instrumental activities of daily living (IADL). The present study examined this association among older adults. Methods: One hundred ten community-dwelling older adults completed a self-report measure of acute (past 24 hr) and chronic (past 2 weeks) expressive suppression, a timed test of IADL, and the Behavioral Dyscontrol Scale as a measure of EF. Results: High chronic expressive suppression was related to slow IADL performance beyond covariates (age, IQ, depression), but only for individuals with low EF. High acute expressive suppression was associated with lower accuracy on IADL tasks beyond covariates (IQ, depression), but this association was fully explained by EF. Conclusions: The current results suggest that expressive suppression is associated with less efficient and more error-prone IADL performance. EF fully accounted for the relationship between acute expressive suppression and IADL performance, showing that suppression is a risk factor for both poorer EF performance and functional lapses in daily life. Furthermore, individuals with weaker EF may be particularly vulnerable to the effect of chronic expressive suppression. (JINS, 2019, 25, 718–728)

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