Performance-based instrument to assess functional capacity in community-dwelling older adults.

Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. OBJECTIVE: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. METHODS: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL's). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. RESULTS: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. CONCLUSION: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

Capacidade Funcional (CF) é um mediador entre as funções neuropsicológica e a funcionalidade no mundo real, mas existe uma falta de evidências da sua correlação em idosos vivendo em comunidade. Objetivo: O objetivo foi determinar a CF de idosos da comunidade utilizando o UCSD Performance-based Skills Assessment (UPSA) e avaliar sua correlação com testes de rastreio cognitivo. Métodos: Participantes de casas de convivência foram selecionados conforme critérios de inclusão: fluência no Português; 60 ou mais anos; auto relato de independência. Critérios de exclusão foram: demência ou outro diagnóstico do DSM-5; ideação suicida ou tentativa, não adesão a ao estudo; envolvimento em estudo farmacológicos ou intervenção psicoterápica. A CF foi determinado pelo UPSA, UPSA abreviado (UPSA-B) e escala Instrumental de Atividade de Vida Diária (AIVD). O Mini-Exame do Estado Mental (MEEM), Teste de Memória de Figuras (TMF), Teste de Fluência Verbal (TFV) e Teste do Desenho do Relógio (TDR) foram utilizados no rastreio cognitivo. Um total de 35 sujeitos com idade média de 72 anos, predominantemente do sexo feminino (88,6%) e escolaridade média de 11,25 anos foram avaliados. Resultados: A pontuação média do UPSA e UPSA-B foram 78,5 e 70, respectivamente. Uma correlação foi observada entre o UPSA e AIVD, MEEM e TFV. Conclusão: O UPSA é um teste de rastreamento da CF de idosos da comunidade apresentando correlação positiva com testes de rastreio cognitivo.

Performance-based instrument to assess functional capacity in community-dwelling older adults / Instrumento baseado em desempenho para avaliar a Capacidade Funcional em Idosos da Comunidade

ABSTRACT Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. Objective: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. Methods: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL's). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. Results: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. Conclusion: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

RESUMO Capacidade Funcional (CF) é um mediador entre as funções neuropsicológica e a funcionalidade no mundo real, mas existe uma falta de evidências da sua correlação em idosos vivendo em comunidade. Objetivo: O objetivo foi determinar a CF de idosos da comunidade utilizando o UCSD Performance-based Skills Assessment (UPSA) e avaliar sua correlação com testes de rastreio cognitivo. Métodos: Participantes de casas de convivência foram selecionados conforme critérios de inclusão: fluência no Português; 60 ou mais anos; auto relato de independência. Critérios de exclusão foram: demência ou outro diagnóstico do DSM-5; ideação suicida ou tentativa, não adesão a ao estudo; envolvimento em estudo farmacológicos ou intervenção psicoterápica. A CF foi determinado pelo UPSA, UPSA abreviado (UPSA-B) e escala Instrumental de Atividade de Vida Diária (AIVD). O Mini-Exame do Estado Mental (MEEM), Teste de Memória de Figuras (TMF), Teste de Fluência Verbal (TFV) e Teste do Desenho do Relógio (TDR) foram utilizados no rastreio cognitivo. Um total de 35 sujeitos com idade média de 72 anos, predominantemente do sexo feminino (88,6%) e escolaridade média de 11,25 anos foram avaliados. Resultados: A pontuação média do UPSA e UPSA-B foram 78,5 e 70, respectivamente. Uma correlação foi observada entre o UPSA e AIVD, MEEM e TFV. Conclusão: O UPSA é um teste de rastreamento da CF de idosos da comunidade apresentando correlação positiva com testes de rastreio cognitivo.

A systematic review of a functional assessment Tool: UCSD Performance-based skill assessment (UPSA).

Performance based assessment instruments have been employed in functional capacity measurement of mental disorders. The aim of this systematic review was to identify the psychometric properties of the UCSD Performance-based Skill Assessment (UPSA). A search was conducted using the PRISMA protocol and 'UPSA' as key word term on electronic databases, with a date range for articles published from 2001-2017. Published studies involving community-dwelling adults were included. Pharmacological and/or clinical interventions involving clinical outcomes and/or institutionalized samples were excluded. Data related to construct validity, test-retest reliability and sensitivity/specificity were extracted, summarized and analyzed according to UPSA versions and psychiatric disorders. Fifty-eight studies including 8782 Community-dwelling adults met selection criteria. Data supporting the construct and known-groups validity were extracted from 41 studies involving Schizophrenia and schizoaffective disorders and 17 studies involving other metal illness. The UPSA was culturally adapted to 8 different languages and employed in 17 countries. Few studies reported sensitivity and specificity and the cut-off points could not be generalized. Moderate to strong evidence of construct validity and test-retest reliability was found. Few studies proposed cut-off points. The UPSA showed good psychometric properties in different versions including those culturally adapted.