The Relationship Between Performance On Cognitive Screening Tests And Everyday Functioning In Older Adults With Mild Cognitive Impairment

Introduction:

Occupational therapists (OTs) play an important role in evaluating the cognitive and functional abilities of older adults with mild cognitive impairment (MCI) in the acute hospital setting. Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) and the Addenbrooke’s Cognitive Examination (ACE-III) are regularly administered by acute hospital OTs to assist in predicting the functional capacities of individuals with MCI. However findings from clinical practice show that performance on cognitive screening tools is not always consistent with functional task performance.

Aims and Objectives:

The aim of the research was to explore the relationship between cognitive test performance and instrumental activity of daily living (IADL) function in older adults with MCI in the acute hospital setting. The objectives of the study were to determine which cognitive screening tool (MoCA or ACE-III) was most strongly related to IADL function, to determine the relationship between individual cognitive subdomains of the MoCA/ACE-III and IADL function and to explore the influence of various cognitive and demographic variables on IADL function.

Methods:

Forty older adults with MCI were recruited from an acute hospital setting for this cross-sectional study. All participants completed cognitive screening tests (MoCA and ACE-III) and an objective measure of everyday functioning (Executive Function Performance Test, EFPT). Correlation and regression analyses were conducted to explore the relationship between cognitive test performance and functional capacity.

Results:

The mean (±SD) age of the participants was 79.9 (±8.1) years with 52.5% (n=21) being female. A low correlation was found between EFPT total scores and MoCA total scores (r= -0.22, p

Conclusion:

Results demonstrated low-moderate relationships between performance on the MoCA/ ACE-III cognitive screening tests and IADL function as measured by the EFPT. It is evident that performance on cognitive screening tests alone does not provide the clinician with a definitive evaluation of the functional abilities of older adults with MCI in the acute hospital setting.

Implications of Findings

This research provides the clinician with a better understanding of the relationship between performance on cognitive screening tests and functional abilities in older adults with MCI in the acute hospital setting. It highlights the importance of examining cognitive subdomains of screening tests rather than just the overall score. It also supports the value of functional assessment for individuals with MCI. This study demonstrated that the ACE-III was more strongly related to IADL function than the MoCA and this indicates that the ACE-III should be used when assessing individuals with MCI.