Functional cognitive performance augments cognitive screening data in older adults

BackgroundUnderstanding the association of older adults’ cognitive ability with performance of instrumental activities of daily living (IADL) is critical to identifying their community health care support needs. We compared differences in performance-based IADL assessment scores among older adults a...

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Main Authors: Timothy S. Marks, Gordon Muir Giles, Dorothy Farrar Edwards
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1535146/full
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author Timothy S. Marks
Gordon Muir Giles
Dorothy Farrar Edwards
author_facet Timothy S. Marks
Gordon Muir Giles
Dorothy Farrar Edwards
author_sort Timothy S. Marks
collection DOAJ
description BackgroundUnderstanding the association of older adults’ cognitive ability with performance of instrumental activities of daily living (IADL) is critical to identifying their community health care support needs. We compared differences in performance-based IADL assessment scores among older adults according to their cognitive ability as measured by the Montreal Cognitive Assessment (MoCA).MethodsUsing data from a larger study we performed a cross-sectional analysis of 259 community-dwelling adults aged 55–93 years. Participants were categorized into one of three groups based on their MoCA score: mildly impaired (19–22), borderline (23–25), or unimpaired (26–30). The Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST) and the Weekly Calendar Planning Activity 17-item version (WCPA-17) were used to assess IADL. A MANCOVA analyzed the effect of MoCA group on the performance-based IADL assessments while controlling for education.ResultsThe MANCOVA was statistically significant, F(4, 508) = 16.445, p < 0.001; Wilks’ λ = 0.784; ηp2 = 0.115. Follow-up univariate ANCOVAs showed that PCST Total Cues adjusted mean score [F(2, 255) = 20.006, p < 0.001; ηp2 = 0.136] and WCPA-17 Accuracy adjusted mean scores [F(2, 255) = 23.216, p < 0.001; ηp2 = 0.154] were significantly different among MoCA groups, with medium-large effect sizes.ConclusionThe tripartite group categorization of the MoCA largely parallels ability on two independent performance-based IADL assessments, a subset of individuals borderline or unimpaired on the MoCA had difficulties with complex IADL identified by performance-based IADL assessments indicating comprehensive evaluations of older adults would benefit from including both types of assessments.
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spelling doaj-art-abcae6c15b43448aa1216d716473342e2025-08-20T03:22:04ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-06-011710.3389/fnagi.2025.15351461535146Functional cognitive performance augments cognitive screening data in older adultsTimothy S. Marks0Gordon Muir Giles1Dorothy Farrar Edwards2Department of Occupational Therapy, University of Missouri, Columbia, MO, United StatesDepartment of Occupational Therapy, Samuel Merritt University, Oakland, CA, United StatesDepartments of Kinesiology and Medicine, University of Wisconsin-Madison, Madison, WI, United StatesBackgroundUnderstanding the association of older adults’ cognitive ability with performance of instrumental activities of daily living (IADL) is critical to identifying their community health care support needs. We compared differences in performance-based IADL assessment scores among older adults according to their cognitive ability as measured by the Montreal Cognitive Assessment (MoCA).MethodsUsing data from a larger study we performed a cross-sectional analysis of 259 community-dwelling adults aged 55–93 years. Participants were categorized into one of three groups based on their MoCA score: mildly impaired (19–22), borderline (23–25), or unimpaired (26–30). The Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST) and the Weekly Calendar Planning Activity 17-item version (WCPA-17) were used to assess IADL. A MANCOVA analyzed the effect of MoCA group on the performance-based IADL assessments while controlling for education.ResultsThe MANCOVA was statistically significant, F(4, 508) = 16.445, p < 0.001; Wilks’ λ = 0.784; ηp2 = 0.115. Follow-up univariate ANCOVAs showed that PCST Total Cues adjusted mean score [F(2, 255) = 20.006, p < 0.001; ηp2 = 0.136] and WCPA-17 Accuracy adjusted mean scores [F(2, 255) = 23.216, p < 0.001; ηp2 = 0.154] were significantly different among MoCA groups, with medium-large effect sizes.ConclusionThe tripartite group categorization of the MoCA largely parallels ability on two independent performance-based IADL assessments, a subset of individuals borderline or unimpaired on the MoCA had difficulties with complex IADL identified by performance-based IADL assessments indicating comprehensive evaluations of older adults would benefit from including both types of assessments.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1535146/fullIADLfunctional cognitioncognitionassessmentperformance-based testing
spellingShingle Timothy S. Marks
Gordon Muir Giles
Dorothy Farrar Edwards
Functional cognitive performance augments cognitive screening data in older adults
Frontiers in Aging Neuroscience
IADL
functional cognition
cognition
assessment
performance-based testing
title Functional cognitive performance augments cognitive screening data in older adults
title_full Functional cognitive performance augments cognitive screening data in older adults
title_fullStr Functional cognitive performance augments cognitive screening data in older adults
title_full_unstemmed Functional cognitive performance augments cognitive screening data in older adults
title_short Functional cognitive performance augments cognitive screening data in older adults
title_sort functional cognitive performance augments cognitive screening data in older adults
topic IADL
functional cognition
cognition
assessment
performance-based testing
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1535146/full
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