Department of Psychology, Washington State University, Pullman, WA 99164-4820, USA.
J Int Neuropsychol Soc. 2011 Sep;17(5):853-64. doi: 10.1017/S1355617711000865. Epub 2011 Jun 27.
Neuropsychologists are often asked to answer questions about the effects of cognitive deficits on everyday functioning. This study examined the relationship between and the cognitive correlates of self-report, performance-based, and direct observation measures commonly used as proxy measures for everyday functioning. Participants were 88 community-dwelling, cognitively healthy older adults (age 50-86 years). Participants completed standardized neuropsychological tests and questionnaires, and performed eight activities of daily living (e.g., water plants, fill a medication dispenser) while under direct observation in a campus apartment. All proxy measures of everyday function were sensitive to the effects of healthy cognitive aging. After controlling for age, cognitive predictors explained a unique amount of the variance for only the performance-based behavioral simulation measure (i.e., Revised Observed Tasks of Daily Living). The self-report instrumental activities of daily living (IADL) and the performance-based everyday problem-solving test (i.e., EPT) did not correlate with each other; however, both were unique predictors of the direct observation measure. These findings suggest that neuropsychologists must be cautious in making predictions about the quality of everyday activity completion in cognitively healthy older adults from specific cognitive functions. The findings further suggest that a self-report of IADLs and the performance-based EPT may be useful measures for assessing everyday functional status in cognitively healthy older adults.
神经心理学家经常被要求回答有关认知缺陷对日常功能影响的问题。本研究考察了作为日常功能替代测量常用的自我报告、基于表现和直接观察测量之间的关系和认知相关性。参与者为 88 名居住在社区、认知健康的老年人（50-86 岁）。参与者完成了标准化的神经心理学测试和问卷，并在校园公寓内进行了直接观察，完成了八项日常生活活动（例如，浇水植物、填充药物分配器）。所有日常功能的替代测量都对健康认知老化的影响敏感。在控制年龄后，认知预测因素仅对基于表现的行为模拟测量（即修订后的日常观察任务）解释了独特的方差量。自我报告的工具性日常生活活动（IADL）和基于表现的日常解决问题测试（即 EPT）彼此之间没有相关性；然而，两者都是直接观察测量的独特预测因素。这些发现表明，神经心理学家在根据特定认知功能对认知健康的老年人完成日常活动的质量进行预测时必须谨慎。这些发现进一步表明，IADL 的自我报告和基于表现的 EPT 可能是评估认知健康老年人日常功能状态的有用措施。
