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Development of an instrument for measuring activities of daily living in persons with suspected cognitive impairment
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.ORCID iD: 0000-0003-4166-7269
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
2016 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 3, 230-239 p.Article in journal (Refereed) Published
Abstract [en]

Background: According to the Swedish National Board of Health and Welfare, structured assessment of function and activity has high priority when investigating for dementia.

Aim/objectives: The aim was to develop and psychometrically test an instrument to measure self-reported and/or informant-reported ability to perform activities of daily living in persons with suspected cognitive impairment.

Material and methods: The Cognitive Impairment in Daily Life (CID) instrument has been developed in several phases. Content validity was achieved through five expert panels using a Content Validity Index (CVI). The content was tested further in a pilot study of 51 patients and 49 relatives from primary care or a specialist memory clinic.

Results: Content validity was good with a CVI index of 0.83. All patients considered that relevant activities were included. Most relatives considered that the activities included in the instrument were adequate and captured the patients’ difficulties in daily life. Some adjustments to the items and scale were suggested and these were done after each phase. In general, relatives indicated more difficulties than patients.

Conclusion: The CID instrument seems promising in terms of content validity. Further testing of reliability and construct validity is ongoing.

Place, publisher, year, edition, pages
2016. Vol. 23, no 3, 230-239 p.
Keyword [en]
Cognition, dementia investigation, instrument development
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-115306DOI: 10.3109/11038128.2016.1139621ISI: 000374634100006OAI: oai:DiVA.org:liu-115306DiVA: diva2:794857
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Cognitive impairment and its consequences in everyday life
Open this publication in new window or tab >>Cognitive impairment and its consequences in everyday life
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to improve knowledge of the consequences of cognitive dysfunction in everyday life and of instruments to make these assessments. The thesis contains four studies each of different design using different populations.

In study I, the relationship between cognitive function, ability to perform activities of daily living and perceived health-related quality of life were investigated in a population of 85-year-old individuals in the community of Linköping (n = 373). The study was part of the Elderly in Linköping Screening Assessment 85 (ELSA 85). Even mild cognitive dysfunction correlated with impaired ability to perform activities of daily living and lower health-related quality of life.

In study II, the diagnostic accuracy and clinical utility of Cognistat, a cognitive screening instrument, were evaluated for identifying individuals with cognitive impairment in a primary care population. Cognistat has relatively good diagnostic accuracy with a sensitivity of 0.85, a specificity of 0.79 and a Clinical Utility Index (CUI) of 0.72. The corresponding values were 0.59, 0.91 and 0.53 for the Mini Mental State Examination (MMSE), and 0.26, 0.88 and 0.20 for the Clock Drawing Test (CDT).

In study III, the aim was to develop an instrument measuring self-perceived or caregiver reported ability to perform everyday life activities in persons with suspected cognitive impairment or dementia and to perform psychometric testing of this instrument, named the Cognitive Impairment in Daily Life (CID). The CID was found to have good content validity.

In study IV, experiences of cognitive impairment, its consequences in everyday life and the need for support in persons with mild cognitive impairment (MCI) or mild dementia and their relatives were explored. Interviews were performed with five people with MCI, eight people with mild dementia and their relatives (n = 13). The main finding was that persons with MCI and dementia experienced cognitive changes that could be burdensome and result in changed activity patterns.

In conclusion, the findings support earlier research and show that cognitive dysfunction even at mild stages has an impact on everyday life and reduces perceived quality of life. To improve interventions for persons with cognitive impairment, it is important to assess not only cognitive function but also its consequences in everyday life activities.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 54 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1452
Keyword
Activities of daily living, assessment, dementia, mild cognitive impairment, occupational therapy, quality of life
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:liu:diva-115349 (URN)10.3384/diss.diva-115349 (DOI)978-91-7519-109-6 (ISBN)
Public defence
2015-04-10, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2016-03-29Bibliographically approved

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Johansson, MariaMarcusson, JanWressle, Ewa

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Public Health, Global Health, Social Medicine and Epidemiology

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