Department of Psychology, University of Utah, Salt Lake City, UT, USA.
J Int Neuropsychol Soc. 2024 May;30(4):350-359. doi: 10.1017/S1355617723000723. Epub 2024 Mar 11.
Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities to traditional EF measures.
Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol.
The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS.
Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.
大量研究表明，执行功能测试（EF）可预测工具性日常生活活动（IADLs），但它们的生态有效性仍受到广泛批评。改良六要素测试（MSET）是一种纸笔测试，旨在模拟日常生活的要求，假设这将导致更具生态有效性的测试。尽管 MSET 在其能够捕捉各种人群认知缺陷的能力方面已得到广泛验证，但支持其能够预测日常生活中的功能的证据却参差不齐。本研究旨在检验 MSET 预测通过三种不同模式评估的 IADLs 的能力，与传统 EF 测量相比。
参与者（93 名年龄在 60-85 岁之间的成年人）完成了 MSET、传统的 EF 测量（Delis-Kaplan 执行功能系统；D-KEFS）以及实验室中的自我报告和基于表现的 IADLs。然后，参与者使用 DAILIES 协议在家中完成了三周的 IADL 任务。
MSET 仅预测在家中完成的 IADLs，而 D-KEFS 则预测所有三种模式的 IADLs。此外，当将 D-KEFS 与 MSET 进行比较时，D-KEFS 预测了基于家庭的 IADLs，而 MSET 则没有做出贡献。
在预测社区居住的老年人的 IADLs 方面，传统的 EF 测试（D-KEFS）似乎优于 MSET。本研究结果表明，在评估认知功能健康的老年人的功能独立性时，不应用 MSET 代替传统测量。
