Department of Neurology.
Air Quality Research Center.
Neuropsychology. 2019 Nov;33(8):1121-1135. doi: 10.1037/neu0000591. Epub 2019 Aug 26.
Compensatory strategies such as assistive technology, external reminders, and environmental cues may help support instrumental activities of daily living (IADLs) and independence. However, functional ability is most often evaluated in clinical settings where everyday compensation cannot be readily observed. The present study used a novel, real-world evaluation of everyday activities (prospective memory, household chores, complex IADLs, and planning tasks) to examine the impact of compensation.
Fifty community dwelling older adults were recruited with cognitive status ranging from healthy to mildly impaired. Participants completed a battery of validated performance-based and cognitive tasks, an IADL questionnaire (also completed by an informant), and real-world activities carried out in their own homes.
The real-world evaluation demonstrated adequate interrater reliability (intraclass coefficient = 0.92) and construct validity (r = 0.55). Compensation improved real-world task outcome on prospective memory and household chores tasks. Further, cognition emerged as a moderator between compensation and prospective memory task outcome. Participants' ratings on an IADL questionnaire were related to real-world and performance-based functioning whereas informants' ratings were related to performance-based tasks and cognition.
Our results suggest that proxy measures of functional ability (i.e., performance-based, cognitive, and IADL questionnaire measures) do not fully capture the complexity of real-world performance for nondemented community dwelling older adults. Compensation appeared to improve prospective memory performance, particularly for individuals with average to low average cognitive abilities. A difference in IADL questionnaire ratings suggest that participants may be better able to judge their real-world performance than informants. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
辅助技术、外部提醒和环境提示等补偿策略可能有助于支持工具性日常生活活动（IADLs）和独立性。然而，功能能力通常在临床环境中进行评估，在临床环境中，日常补偿无法轻易观察到。本研究使用一种新颖的、真实世界的日常活动评估（前瞻性记忆、家务、复杂的 IADL 和规划任务）来检查补偿的影响。
招募了 50 名居住在社区的认知状态从健康到轻度受损的老年人。参与者完成了一系列经过验证的基于表现和认知的任务、IADL 问卷（也由知情人完成）以及在自己家中进行的真实世界活动。
真实世界的评估表现出足够的评分者间可靠性（组内相关系数=0.92）和构念效度（r=0.55）。补偿改善了前瞻性记忆和家务任务的真实世界任务结果。此外，认知作为补偿和前瞻性记忆任务结果之间的调节剂出现。参与者对 IADL 问卷的评分与真实世界和基于表现的功能相关，而知情人的评分与基于表现的任务和认知相关。
我们的结果表明，代理的功能能力测量（即基于表现的、认知的和 IADL 问卷测量）不能完全捕捉认知正常的社区居住老年人真实世界表现的复杂性。补偿似乎改善了前瞻性记忆表现，特别是对于平均或低平均认知能力的个体。IADL 问卷评分的差异表明，参与者可能比知情人更能判断自己的真实世界表现。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
