Screening older adults for potential deficits in IADL using the Menu Task and Medi‐Cog‐R

Abstract

AbstractBackgroundThe identification of deficits in functional performance is critical to sustaining the community independence of older adults. Screening for difficulties in the performance of cognitively demanding instrumental activities of daily living (IADL) can facilitate earlier identification of and intervention for people with impairment (Rodakowski et al., 2014). We examined whether two brief performance‐based screening measures ‐ the Menu Task and the Medi‐Cog‐R ‐ can identify those at risk of functional cognitive deficits as indicated by poor performance on the Weekly Calendar Planning Activity (WCPA).MethodUsing a cross‐sectional design we administered the Menu Task, Medi‐Cog‐R, and the WCPA to community dwelling adults 55 years of age and older (N = 280). Using established cut scores, we examined the sensitivity and specificity of the two screening measures to poor performance on WCPA Accuracy (≤ 20th percentile). Known‐group construct validity were examined by comparing impaired and unimpaired groups on the screening measures on subtests of the WCPA.ResultThe sample was 73.57% female and 73.57% white. Mean age was 69.72 (SD = 8.81) and mean education was 15.61 (SD = 3.30) years. The Menu Task demonstrated a sensitivity of .84 and a specificity of .62 and the Medi‐Cog‐R demonstrated a sensitivity of .77 and a specificity of .66 in correctly classifying individuals with potential for impaired IADL as indicated by a score at or below the 20th percentile on the WCPA. The impaired groups on both screening measures scored significantly lower on WCPA subtests of Accuracy, Appointments Entered, Efficiency, Rules, and Strategies than the unimpaired group (p < .001).ConclusionThe Menu Task and the Medi‐Cog‐R could both alert clinicians to the potential for functional cognitive deficits and need for IADL support in community dwelling older adults. Performance‐based screening measures of functional cognition can be used to prompt further assessment and intervention to promote community independence.