Suchy Yana, Gereau Mora Michelle, DesRuisseaux Libby A, Brothers Stacey L
Department of Psychology, University of Utah, Salt Lake City, UT, USA.
J Int Neuropsychol Soc. 2023 Nov;29(9):850-858. doi: 10.1017/S1355617723000048. Epub 2023 Apr 14.
Research shows that cognitively healthy older adults with mild executive function (EF) weaknesses are vulnerable to the negative impacts of life complexity (or daily busyness) when performing instrumental activities of daily living (IADLs). However, past research assessed life complexity only at one timepoint, not capturing daily fluctuations. Importantly, fluctuations in busyness can themselves have deleterious impacts on functioning. This study extended past research by examining whether (1) in daily busyness would be more detrimental than of busyness to performance of IADLs, and (2) EF assessed at home would moderate deleterious impact of busyness on IADLs.
Fifty-two community-dwelling older adults aged 60 to 95 completed daily IADL tasks and daily measures of EF and busyness via ecological momentary assessment, independently at home for 18 days.
(1) In a subset of participants with mild EF weaknesses, high in busyness across days was associated with fewer tasks completed ; and (2) across all participants (regardless of EF), high of daily busyness were associated with fewer tasks completed .
Findings indicate that high variability in daily busyness, potentially reflecting a lack of daily routine, was associated with IADL errors among cognitively healthy older adults with mild EF weaknesses. Additionally, consistently high levels of busyness were associated with failures to complete tasks, or failures to complete them on time, regardless of EF. These results further support the Contextually Valid Executive Assessment (ConVExA) model, which posits that EF and contextual factors interact to predict functional outcomes.
研究表明，认知健康但存在轻度执行功能（EF）弱点的老年人在进行日常生活工具性活动（IADL）时，容易受到生活复杂性（或日常忙碌程度）的负面影响。然而，以往的研究仅在一个时间点评估生活复杂性，未捕捉到每日的波动情况。重要的是，忙碌程度的波动本身可能对功能产生有害影响。本研究通过考察以下两点扩展了以往的研究：（1）每日忙碌程度的变异性是否比忙碌程度的平均值对IADL表现更具不利影响；（2）在家中评估的EF是否会缓和忙碌对IADL的有害影响。
52名年龄在60至95岁的社区居住老年人通过生态瞬时评估，在家中独立完成了为期18天的每日IADL任务以及EF和忙碌程度的每日测量。
（1）在一部分存在轻度EF弱点的参与者中，数天内忙碌程度的高变异性与完成的任务较少相关；（2）在所有参与者中（无论EF情况如何），每日忙碌程度的高平均值与完成的任务较少相关。
研究结果表明，每日忙碌程度的高变异性可能反映出缺乏日常规律，这与存在轻度EF弱点的认知健康老年人的IADL错误相关。此外，无论EF情况如何，持续的高忙碌程度与任务未完成或未按时完成相关。这些结果进一步支持了情境有效执行评估（ConVExA）模型，该模型认为EF和情境因素相互作用以预测功能结果。
