title: Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: A systematic review and evaluation of measurement properties.
abstract: Functional cognition is a relatively new concept in assessment of older adults with mild cognitive impairment or dementia. Instruments need to be reliable and valid, hence we conducted a systematic review of observational assessments of task performance used to estimate functional cognition in this population. Two separate database searches were conducted: firstly to identify instruments; and secondly to identify studies reporting on the psychometric properties of the instruments. Studies were analysed using a published checklist and their quality reviewed according to specific published criteria. Clinical utility was reviewed and the information formulated into a best evidence synthesis. We found 21 instruments and included 58 studies reporting on measurement properties. The majority of studies were rated as being of fair methodological quality and the range of properties investigated was restricted. Most instruments had studies reporting on construct validity (hypothesis testing), none on content validity and there were few studies reporting on reliability. Overall the evidence on psychometric properties is lacking and there is an urgent need for further evaluation of instruments.
authors.affiliation: Ageing Work & Health Research Unit, Faculty of Health Sciences, University of Sydney, 75 East St., Lidcombe, 2141, NSW, Australia. Electronic address: jacqueline.wesson@sydney.edu.au.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Wesson
authors.affiliation: Ageing Work & Health Research Unit, Faculty of Health Sciences, University of Sydney, 75 East St., Lidcombe, 2141, NSW, Australia. Electronic address: lindy.clemson@sydney.edu.au.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.affiliation: Dementia Collaborative Research Centre, UNSW, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Australia. Electronic address: h.brodaty@unsw.edu.au.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Department of Developmental Disability Neuropsychiatry, School of Psychiatry, Faculty of Medicine, UNSW, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Australia. Electronic address: s.reppermund@unsw.edu.au.
authors.forename: Simone
authors.initials: S
authors.lastname: Reppermund
mesh_terms: D057189:Checklist; D003071:Cognition; D006801:Humans; D011594:Psychometrics; D015203:Reproducibility of Results; D013647:Task Performance and Analysis
keywords: Dementia; Everyday activities; Functional cognition; Measurement properties; Mild cognitive impairment; Performance based assessment