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Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings
Author(s) -
Fong Tamara G.,
Gleason Lauren J.,
Wong Bonnie,
Habtemariam Daniel,
Jones Richard N.,
Schmitt Eva M.,
Rooij Sophia E.,
Saczynski Jane S.,
Gross Alden L.,
Bean Jonathan F.,
Brown Cynthia J.,
Fick Donna M.,
GruberBaldini Ann L.,
O'Connor Margaret,
Tabloski Patrica A.,
Marcantonio Edward R.,
Inouye Sharon K.
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2015.01.018
Subject(s) - stairs , activities of daily living , cognition , physical medicine and rehabilitation , medicine , physical therapy , rehabilitation , gerontology , stair climbing , psychology , psychiatry , civil engineering , engineering
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.