Verbal test of practical judgment (VPJ): a new test of judgment that predicts functional skills for older adults

ABSTRACT

Objectives: The clinical assessment of older adults’ judgment is important for mitigating safety risks that often precipitate loss of independence. Our national survey of geriatric healthcare providers (N = 496; M years of experience = 17.11 ± 10.60) indicated that formal judgment tests are underutilized in clinical practice. We developed the Verbal Test of Practical Judgment (VPJ) as a new test of judgment for older adults intended to identify difficulty performing instrumental activities of daily living (IADL).

Method: In two prospective studies, participants were long-term care facility residents (age ≥ 50) in Maryland, USA (Study 1, N = 51; Study 2, N = 110) referred to licensed psychologists for neuro-cognitive and mood evaluation by facility attending physicians. Psychometric analyses were performed to examine the construct validity of the VPJ.

Results: The VPJ evidenced adequate reliability and strong construct validity across both studies. Receiver operating characteristic analysis yielded an optimal VPJ cut score for identifying impaired judgment. The VPJ significantly predicted IADL performance beyond clinician and participant ratings.

Conclusion: The VPJ appears to be a valid tool for assessing judgment among older adults with suspected cognitive impairment. VPJ score inferences can inform clinicians on the odds of requiring assistance for specific IADLs.

KEYWORDS:

• Judgment
• cognitive impairment
• functional status
• long-term care
• psychometrics

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Acknowledgments

The authors thank Kevin Lawlor, PsyD, Alex Lupus, PhD, and Tracey Phillips, PhD for their assistance with data collection and Ali Breden for data entry.

Disclosure statement

The corresponding author has ownership rights of the Verbal Test of Practical Judgment (VPJ).

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.