TY - JOUR
T1 - Cognitive and physical demands of activities of daily living in older adults
T2 - Validation of expert panel ratings
AU - Fong, Tamara G.
AU - Gleason, Lauren J.
AU - Wong, Bonnie
AU - Habtemariam, Daniel
AU - Jones, Richard N.
AU - Schmitt, Eva M.
AU - de Rooij, Sophia E.
AU - Saczynski, Jane S.
AU - Gross, Alden L.
AU - Bean, Jonathan F.
AU - Brown, Cynthia J.
AU - Fick, Donna M.
AU - Gruber-Baldini, Ann L.
AU - O'Connor, Margaret
AU - Tabloski, Patrica A.
AU - Marcantonio, Edward R.
AU - Inouye, Sharon K.
AU - The Successful Aging after Elective Surgery Functional Measures Working Group
N1 - Publisher Copyright:
© 2015 by the American Academy of Physical Medicine and Rehabilitation.
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
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U2 - 10.1016/j.pmrj.2015.01.018
DO - 10.1016/j.pmrj.2015.01.018
M3 - Article
C2 - 25661463
AN - SCOPUS:84942989808
SN - 1934-1482
VL - 7
SP - 727
EP - 735
JO - PM and R
JF - PM and R
IS - 7
ER -