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PM R. 2015 Jul;7(7):727-735. doi: 10.1016/j.pmrj.2015.01.018. Epub 2015 Feb 4.

Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings.

Author information

1
Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
2
Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
3
Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.
4
Department of Geriatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
5
University of Massachusetts Medical School and Meyers Primary Care Institute, Worcester, MA.
6
Spaulding Rehabilitation Hospital, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.
7
Birmingham/Atlanta VA GRECC and School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
8
School of Nursing, The Pennsylvania State University, University Park, PA.
9
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
10
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
11
William F. Connell School of Nursing, Boston College, Boston, MA.
12
Departments of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Abstract

BACKGROUND:

Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living.

OBJECTIVES:

To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults.

DESIGN:

Expert panel survey.

SETTING:

Web-based platform.

PARTICIPANTS:

Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers.

METHODS:

Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study.

MAIN OUTCOME MEASUREMENTS:

Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks.

RESULTS:

Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P < .05) and largely physical activities correlated with physical performance (r = 0.15-0.46, P < .05).

CONCLUSIONS:

Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education.

PMID:
25661463
PMCID:
PMC4508212
DOI:
10.1016/j.pmrj.2015.01.018
[Indexed for MEDLINE]
Free PMC Article

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