Cooking task assessment in frail older adults: who performed better at home and in the clinic?

Abstract

Aim:The purpose of this study was to determine: (i) the proportion of frail older adults who demonstrate (a) statistically significant and (b) clinically meaningful differences between home and clinic cooking task performance; and (ii) factors associated with a better performance in each environment. Methods:Thirty-seven participants were evaluated with the Assessment of Motor and Process Skills (AMPS) in home and clinic environments using a counterbalanced design. Demographic, physical, cognitive, psychological, and environmental characteristics were also collected. Results:Thirty-three participants were retained for analysis. A statistically significant difference (> ±2 standard errors of measurement) between environments was found in 33% of the participants on the motor scale and the same proportion on the process scale. A clinically meaningful difference (based on cut-off scores predicting need for assistance) was noted in 30% of the participants. Better performance at home on the process scale was associated with a decrease in some executive functions, while better performance in the clinic on the motor scale was mostly related to a decline in grip strength. Conclusions:Our findings may help occupational therapists identify frail patients for whom home assessments would be advisable prior to discharge so that assistance provided meets their needs at home.