title: Measurement of Functional Cognition and Complex Everyday Activities in Older Adults with Mild Cognitive Impairment and Mild Dementia: Validity of the Large Allen's Cognitive Level Screen.
abstract: OBJECTIVE
  To explore the validity of the Large Allen's Cognitive Level Screen-5 (LACLS-5) as a performance-based measure of functional cognition, representing an ability to perform complex everyday activities in older adults with mild cognitive impairment (MCI) and mild dementia living in the community.
  
  
  METHODS
  Using cross-sectional data from the Sydney Memory and Ageing Study, 160 community-dwelling older adults with normal cognition (CN; N = 87), MCI (N = 43), or dementia (N = 30) were studied. Functional cognition (LACLS-5), complex everyday activities (Disability Assessment for Dementia [DAD]), Assessment of Motor and Process Skills [AMPS]), and neuropsychological measures were used.
  
  
  RESULTS
  Participants with dementia performed worse than CN on all clinical measures, and MCI participants were intermediate. Correlational analyses showed that LACLS-5 was most strongly related to AMPS Process scores, DAD instrumental activities of daily living subscale, Mini-Mental State Exam, Block Design, Logical Memory, and Trail Making Test B. Multiple regression analysis indicated that both cognitive (Block Design) and functional measures (AMPS Process score) and sex predicted LACLS-5 performance. Finally, LACLS-5 was able to adequately discriminate between CN and dementia and between MCI and dementia but was unable to reliably distinguish between CN and MCI.
  
  
  CONCLUSIONS
  Construct validity, including convergent and discriminative validity, was supported. LACLS-5 is a valid performance-based measure for evaluating functional cognition. Discriminativevalidity is acceptable for identifying mild dementia but requires further refinement for detecting MCI.
authors.affiliation: Ageing Work & Health Research Unit, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, 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, Lidcombe, New South Wales, Australia.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.affiliation: Centre for Healthy Brain Ageing, UNSW, Sydney, New South Wales, Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Crawford
authors.affiliation: Centre for Healthy Brain Ageing, UNSW, Sydney, New South Wales, Australia.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Kochan
authors.affiliation: Centre for Healthy Brain Ageing, UNSW, Sydney, New South Wales, Australia; School of Psychiatry, Faculty of Medicine, Dementia Collaborative Research Centre, School of Psychiatry, Australian Graduate School of Management, UNSW, Sydney, New South Wales, Australia; Aged Care Psychiatry and Memory Disorders Clinic, Euroa Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Centre for Healthy Brain Ageing, UNSW, Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.
authors.forename: Simone
authors.initials: S
authors.lastname: Reppermund
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests
keywords: Functional cognition; dementia; everyday activities; instrumental activities of daily living (IADLs); mild cognitive impairment; performance-based assessment