Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

ABSTRACT

Introduction: The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults’ ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions, and the underlying constructs of UFOV performance remain a topic of debate. Method: We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We then explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study. Results: In the four subtest variant of UFOV, only Subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV Subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general nonspeeded cognition, and visual function; the omission of Subtests 1 and 4 from the test score did not affect these associations. Conclusions: UFOV Subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future research should investigate whether shortening UFOV by omitting these subtests is a reliable and valid assessment approach.

KEYWORDS:

• Useful field of view
• instrumental activities of daily living
• functional performance
• cognition
• everyday tasks

Acknowledgements

The authors wish to acknowledge Karlene K. Ball, who was awarded the NIH MERIT grant to conduct the SKILL study, the investigators of SKILL, Daniel L. Roenker, Lesley A. Ross, David L. Roth, Virginia G. Wadley, David E. Vance, the staff of the University of Alabama at Birmingham Center for Research on Applied Gerontology, and the entire ACTIVE study team.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ In light of the skewed distribution of Timed IADL scores, a gamma regression model could be considered more appropriate. OTDL and EPT were scored as the number of correctly answered questions, and, thus, a Poisson regression model is a more sensible analysis strategy. We confirmed that our conclusions are not contingent on this analysis choice and report linear regression analysis to facilitate interpretation and comparison of effect sizes across measures of IADL.

² We, furthermore, used the R-packages boot (1.3.17; Davison & Hinkley, 1997), car (2.0.25; Fox & Weisberg, 2011), cocor (1.1.1; Diedenhofen & Musch, 2015), lavaan (0.5.18; Rosseel, 2012), lmtest (0.9.34; Zeileis & Hothorn, 2002), papaja (0.1.0.9074; Aust & Barth, 2015), paran (1.5.1; Dinno, 2012), psych (1.5.6; Revelle, 2015), and vioplot (0.2; Adler, 2005).

³ The bivariate association between age and UFOV was , 90% CI , for the complete sum score, , , and , 90% CI , for the shortened protocol, , .

Additional information

Funding

This research was supported in part by the National Institutes of Health/National Institute on Aging [grant number 5 R37 AG05739-16, Improvement of Visual Processing in Older Adults, Karlene K. Ball, Principal Investigator].