title: Examination of a cut-off score to express the meaningful activity of people with dementia using iPad application (ADOC).
abstract: OBJECTIVE
  To determine a quantifiable measure to identify patients with dementia who can choose an illustration of meaningful activity using an iPad application, Aid for Decision-making in Occupation Choice (ADOC).
  
  
  METHODS
  We recruited 116 patients from 5 institutions in Japan. Occupational therapists interviewed patients with dementia to determine meaningful activities using ADOC. The most meaningful activity was confirmed by their primary caregivers. The cut-off was estimated from Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Receiver operating characteristic analysis indicated that an MMSE score of 8 was the cut-off for choosing meaningful activities using ADOC. Sensitivity and specificity was 91.0% and 74.1%, respectively, and the area under the curve value was 0.89.
  
  
  CONCLUSIONS
  ADOC can provide individualized information regarding meaningful activities for patients with moderate dementia. Implications for Rehabilitation As dementia progresses, difficulty in expressing needs or desires regarding meaningful activity may increase. The iPad application (Aid for Decision-making in Occupation Choice; ADOC) can be useful to promote shared decision-making through a systematic goal-setting process involving a choice of 95 illustrations describing daily activities. Mini-Mental State Examination (MMSE) score greater than 8 points is required to use the ADOC to choose most meaningful activities. ADOC provides individual information regarding meaningful activities for patients with moderate dementia.
authors.affiliation: Department of Occupational Therapy, Kanagawa University of Human Services , Yokosuka, Kanagawa , Japan .
authors.forename: Kounosuke
authors.initials: K
authors.lastname: Tomori
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nagayama
authors.forename: Yuki
authors.initials: Y
authors.lastname: Saito
authors.forename: Kanta
authors.initials: K
authors.lastname: Ohno
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Nagatani
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D009788:Occupational Therapy / Q000295:instrumentation*; D012372:ROC Curve; D012680:Sensitivity and Specificity
keywords: ADOC; cut-off; dementia; meaningful activity; occupational therapy