A direct functional measure to help ascertain optimal level of residential care.

A brieF direct measure oF daily living skills might help place cognitively impaired elders in suitable living environments. In this study, the Test oF Everyday Functional Abilities (TEFA) as a possible adjunctive measure was investigated. The authors recruited 77 cognitively impaired persons in independent living (IL; N = 26), assisted living (AL; N = 25), and dementia special care (SC; N = 26) units. Participants in IL and AL were administered the TEFA and other instruments at baseline and every 6 months over 18 months and when transFerred to a higher level oF care. Special care subjects were administered the same instruments only at baseline. The TEFA clearly separated IL, AL, and SC residents (P < .0001). A TEFA score >50 suggests adequate Functional competence For IL; a score From 30 to 40 adequate Functional competence For AL; and a score oF <30 probable need For an SC unit in the absence oF a capable spouse.

Comparison of the test of everyday functional abilities with a direct measure of daily function.

OBJECTIVES: To compare scores for dementia patients on a newly developed direct test of instrumental activities of daily living (IADLs) to scores on a widely accepted functional measure. METHODS: In 27 community-dwelling dementia patients, scores for the Test of Everyday Functional Ability (TEFA) were compared with scores on a widely used direct test of daily function (Independent Living Scale; ILS). RESULTS: Mini-Mental State Examination scores ranged from 5 to 28 (mean +/- SD = 20.7 +/- 6.37). There was a highly significant correlation between total TEFA and total ILS scores (r(25) = 0.892, p < 0.001) as well as many of the comparable subscales. CONCLUSION: The TEFA is a valid measure of IADL competence for dementia patients.

Comparison of functional and cognitive donepezil effects in Alzheimer's disease.

Donepezil has been shown to improve aspects of cognitive functioning in persons with Alzheimer's disease (AD), but its impact on instrumental activities of daily living has received little attention. In a within-subject design, 24 community-dwelling persons with AD were treated with open-label donepezil over a 12-month period. To assess functional abilities, a brief, objective measure of instrumental activities of daily living skills was used (Texas Functional Living Scale; TFLS). Global cognitive abilities were assessed with the Mini-Mental State Examination (MMSE). Changes in TFLS and MMSE scores were much the same. Improvements on the TFLS and MMSE were seen over a 3-month period. At 12 months, both TFLS and MMSE scores declined slightly below baseline. These results support an effect of donepezil on cognitive measures and day-to-day function and also suggest that the MMSE reflects well the actual functional ability of persons with moderate AD.

Dyadic short forms of the Wechsler Adult Intelligence Scale-III.

Various short forms of the Wechsler Adult Intelligence Scale (WAIS)/WAIS-R have been developed to obtain estimates of overall intellectual level, although little research of WAIS-III short forms has been published to date. Full Scale IQ (FSIQ) estimatesfromfour WAIS-III dyadic short forms were obtained by entering selected subtest scores from a mixed neurologic/ psychiatric sample (n = 196) into regression equations. Results were cross validated on a second sample (n = 57). Within both samples, WAIS-III FSIQ scores were highly correlated (r = .90-.92, p < .001) with estimated FSIQ scores. Estimated FSIQ fell within 5 points of actual FSIQ in 49% to 74% of cross-validation cases and within 10 points of actual FSIQ in 81% to 93% of the sample. Comparable to findings from previous short-form investigations, actual and estimated FSIQ classification levels agreed in 46% to 67% of cases in the cross-validation sample. These dyadic WAIS-III forms appear appropriate for obtaining gross estimates of FSIQ in similar populations, although caution is recommended in interpreting estimated IQ scores.