title: The Combined Effect of Neuropsychological and Neuropathological Deficits on Instrumental Activities of Daily Living in Older Adults: a Systematic Review.
abstract: To date, studies have consistently demonstrated associations between either neuropsychological deficits or neuroanatomical changes and instrumental activities of daily living (IADL) in aging. Only a limited number of studies have evaluated morphological brain changes and neuropsychological test performance concurrently in relation to IADL in this population. As a result, it remains largely unknown whether these factors independently predict functional outcome. The current systematic review intended to address this lack of information by reviewing the literature on older adults, incorporating studies that examined e.g., normal aging, but also stroke or dementia patients. A comprehensive search of databases (Pubmed, Embase, Medline, Web of Science, PsycINFO) and reference lists was performed, focusing on papers in the English language that examined the combined effect of neuropsychological and neuroanatomical factors on IADL in samples of adults with an average age above 50. In total, 58 potential articles were identified; 20 were included in the review. The results show that especially neuropsychological variables (primarily memory and executive functions) independently predict IADL. Although some unique predictive value of brain morphological changes, such as hippocampal atrophy, was found, support for the importance of white matter changes was limited. However, the results of the studies reviewed are diverse, and appear to be at least partially determined by the variables included. For example, studies were less likely to find an independent effect of cognition if they solely employed a cognitive screening instrument. This indicates that a structured examination of neuroanatomical and neuropsychological correlates of IADL in different patient populations is warranted.
authors.affiliation: Department of Medical Psychology, Gelre Medical Centre, Zutphen, The Netherlands.
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Overdorp
authors.affiliation: Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands.|Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Geriatric Medicine and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Roy P C
authors.initials: RP
authors.lastname: Kessels
authors.affiliation: Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands.|Department of Geriatric Medicine and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jurgen A
authors.initials: JA
authors.lastname: Claassen
authors.affiliation: Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6500, HE, Nijmegen, The Netherlands. j.oosterman@donders.ru.nl.
authors.forename: Joukje M
authors.initials: JM
authors.lastname: Oosterman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000523:psychology*; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D003072:Cognition Disorders / Q000473:pathology* / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology; D006801:Humans; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: Executive function; Gray matter; Hippocampus; Instrumental activities of daily living; Magnetic resonance imaging; Memory; White matter