title: Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings.
abstract: BACKGROUND
  Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living.
  
  
  OBJECTIVE
  To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults.
  
  
  METHODS
  Expert panel survey.
  
  
  METHODS
  Web-based platform.
  
  
  METHODS
  Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers.
  
  
  METHODS
  Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study.
  
  
  METHODS
  Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks.
  
  
  RESULTS
  Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P < .05) and largely physical activities correlated with physical performance (r = 0.15-0.46, P < .05).
  
  
  CONCLUSIONS
  Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education.
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Tamara G
authors: TG
authors: Fong
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Lauren J
authors: LJ
authors: Gleason
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Bonnie
authors: B
authors: Wong
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.
authors: Daniel
authors: D
authors: Habtemariam
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.
authors: Richard N
authors: RN
authors: Jones
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.
authors: Eva M
authors: EM
authors: Schmitt
authors: Department of Geriatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Sophia E
authors: SE
authors: de Rooij
authors: University of Massachusetts Medical School and Meyers Primary Care Institute, Worcester, MA.
authors: Jane S
authors: JS
authors: Saczynski
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.
authors: Alden L
authors: AL
authors: Gross
authors: Spaulding Rehabilitation Hospital, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.
authors: Jonathan F
authors: JF
authors: Bean
authors: Birmingham/Atlanta VA GRECC and School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors: Cynthia J
authors: CJ
authors: Brown
authors: School of Nursing, The Pennsylvania State University, University Park, PA.
authors: Donna M
authors: DM
authors: Fick
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
authors: Ann L
authors: AL
authors: Gruber-Baldini
authors: Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Margaret
authors: M
authors: O'Connor
authors: William F. Connell School of Nursing, Boston College, Boston, MA.
authors: Patrica A
authors: PA
authors: Tabloski
authors: Departments of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Edward R
authors: ER
authors: Marcantonio
authors: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Sharon K
authors: SK
authors: Inouye
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology*; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D016138:Walking / Q000502:physiology*