日常任务中细微的效率低下表明老年人早期存在功能障碍:对临床实践和研究的启示。

Subtle inefficiencies in everyday tasks indicate early functional difficulties in older adults: Implications for clinical practice and research.

作者信息

McKniff Moira, Holmqvist Sophia, Kaplan Marina, Simone Stephanie M, Tassoni Molly B, Mis Rachel E, Giovannetti Tania

机构信息

Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA.

Dell Medical School at the University of Texas at Austin, AustinTX, USA.

出版信息

Clin Neuropsychol. 2025 Apr 30:1-20. doi: 10.1080/13854046.2025.2497381.

Abstract

: This study investigated the validity and reliability of subtle errors and slowing in simple everyday tasks (Naturalistic Action Test [NAT]) to assess mild functional difficulties in older adults with mild cognitive impairmen (MCI). : Older adults ( = 111, MAge= 73.45; SD= 6.53) classified as having healthy cognition (HC) or MCI completed neuropsychological testing and two NAT tasks (breakfast and lunch) twice, separated by 4-6 wk. NATs were scored for subtle, inefficient actions (i.e., micro-errors) and the average time (in sec) to complete a task step. Participants with MCI made significantly more micro-errors [ (1, 109) = 8.78, = .004, partial = 0.07] and had a significantly longer average time per step [ (1, 109) = 13.98, < .001, partial = 0.11] than participants with HC. Micro-errors correlated with tests of episodic memory ( = -0.237, = .012) and executive functioning ( = -0.201, = .035), whereas average time per step correlated only with episodic memory ( = -0.300, = .0001). Test-retest reliability was good for average time per step (ICC = .872, < .001) and moderate for micro-errors (ICC = .675, < .001). Measures of inefficient actions and performance time in familiar everyday tasks demonstrated strong to adequate construct and concurrent validity, as well as test-retest- and inter-rater reliability, supporting their use for the quantifying mild functional difficulties. Future studies should explore this scoring approach to develop early markers of functional disability or dementia risk.

摘要

本研究调查了简单日常任务中的细微错误和动作迟缓(自然主义行动测试[NAT])在评估轻度认知障碍(MCI)老年人轻度功能困难方面的有效性和可靠性。111名年龄在73.45岁(标准差=6.53)的老年人被分类为具有健康认知(HC)或MCI,他们完成了神经心理学测试以及两项NAT任务(早餐和午餐),两次测试间隔4至6周。对NAT任务进行评分,评估细微、低效的动作(即微错误)以及完成一个任务步骤的平均时间(以秒为单位)。与HC参与者相比,MCI参与者出现的微错误显著更多(F(1, 109) = 8.78,p = .004,偏η² = 0.07),且每一步的平均时间显著更长(F(1, 109) = 13.98,p < .001,偏η² = 0.11)。微错误与情景记忆测试相关(r = -0.237,p = .012)和执行功能测试相关(r = -0.201,p = .035),而每一步的平均时间仅与情景记忆相关(r = -0.300,p = .0001)。重测信度对于每一步的平均时间来说良好(组内相关系数[ICC] = .872,p < .001),对于微错误来说中等(ICC = .675,p < .001)。熟悉的日常任务中的低效动作和执行时间测量显示出较强到足够的结构效度和同时效度,以及重测信度和评分者间信度,支持将其用于量化轻度功能困难。未来的研究应探索这种评分方法,以开发功能残疾或痴呆风险的早期标志物。

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