An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment

• Published in: Journal of clinical and experimental neuropsychology Vol. 34; no. 1; pp. 11 - 34
• Main Author: Gold, David A.
• Format: Journal Article
• Language: English
• Published: Hove Taylor & Francis Group 01.01.2012; Psychology Press
• Subjects: Activities of daily living; Activities of Daily Living - psychology; Aging; Assessment and classification; Biological and medical sciences; Cognitive correlates of everyday functioning; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - psychology; Executive Function - physiology; Geriatrics; Humans; Instrumental activities of daily living; Medical sciences; Mild cognitive impairment; Motor Skills - physiology; Neuropsychological Tests; Physical Examination; Prediction of future decline; Predictive Value of Tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Surveys and Questionnaires; Human; Evaluation; Assessment and classification; Cognitive disorder; Daily living; Prediction; Activity; Cognition; Classification; mild cognitive impairment; Cognitive correlates of everyday functioning; Instrumental activities of daily living; Prediction of future decline; Elderly
• ISSN: 1380-3395; 1744-411X; 1744-411X
• DOI: 10.1080/13803395.2011.614598

Basic activities of daily living (ADL) are self-maintenance abilities such as dressing or bathing. Instrumental ADL (IADL) are more complex everyday tasks, such as preparing a meal or managing finances ( Lawton & Brody, 1969 ). IADL questionnaires play an important role in assessing the functional abilities of older adults and evaluating the impact of cognitive impairment on routine activities. This paper examined the cognitive processes that underlie IADL performance and concluded that the accurate and reliable execution of IADL likely draws upon the integrity of a wide range of cognitive processes. This review examined IADL in mild cognitive impairment (MCI) because of the controversial nature of distinguishing a significant decline in functional abilities in those with MCI versus dementia or MCI versus cognitively normal aging. The challenges of investigating IADL empirically were explored, as well as some of the reasons for the inconsistent findings in the literature. A review of questionnaire-based assessments of IADL indicated that: MCI can be distinguished statistically from healthy older adults and dementia, individuals with multiple domain MCI are more impaired on IADL than those with single domain MCI, mild IADL changes can be predictive of future cognitive decline, and the ability to manage finances may be among the earliest IADL changes in MCI and a strong predictor of conversion to dementia. This paper concluded with recommendations for more sensitive and reliable IADL questionnaires.