Can deficits in functional capacity and practical judgment indicate cognitive impairment in older adults?

Abstract

Neuropsychological literature has demonstrated a significant relationship between cognitive decline and functional capacity, but the directionality of this relationship is still not well understood. Further, the construct of practical judgment has been linked to both cognitive impairment and functional capacity, but these associations are still under-researched. Moreover, few studies to date have examined the relationships among all three constructs utilizing performance-based, ecologically valid and psychometrically sound measures. The present study aimed to address this gap in published literature and investigated whether a practical judgment and functional capacity can help differentiate individuals with cognitive dysfunction from those without. Participants were 270 community-dwelling individuals aged 56–95 years referred for neuropsychological evaluation in an outpatient setting. Bivariate correlations revealed moderate to strong relationships among the three studied variables. Additionally, logistic regression analysis indicated that ability to make sound practical judgments and ability to perform instrumental activities of daily living (IADL) can be used as indicators of cognitive impairment. The clinical implications of these findings are discussed.

Keywords:

• Activities of daily living
• cognitive impairment
• functional capacity
• judgment
• older adults

Acknowledgments

Writing of this manuscript was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, and the Department of Veterans Affairs Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC).

Disclosure statement

The authors report no conflicts of interest. The views, opinions and/or findings contained in this article are those of the authors and should not be construed as an official Regent University, US Department of Veterans Affairs or US Department of Defense position, policy or decision, unless so designated by other official documentation.