ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1535146
This article is part of the Research TopicThe Open Challenges of Cognitive Frailty: Risk Factors, Neuropsychological Profiles and Psychometric Assessment for Healthy AgingView all 19 articles
Functional cognitive performance augments cognitive screening data in older adults
Provisionally accepted
- 1University of Missouri, Columbia, United States
- 2Samuel Merritt University, Oakland, California, United States
- 3University of Wisconsin-Madison, Madison, Wisconsin, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Understanding the association of older adults’ cognitive ability with performance of instrumental activities of daily living (IADL) is critical to identifying their community health care support needs. We compared differences in performance-based IADL assessment scores among older adults according to their cognitive ability as measured by the Montreal Cognitive Assessment (MoCA). Methods: Using data from a larger study we performed a cross-sectional analysis of 259 community-dwelling adults aged 55-93 years. Participants were categorized into one of three groups based on their MoCA score: mildly impaired (19-22), borderline (23-25), or unimpaired (26-30). The Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST) and the Weekly Calendar Planning Activity 17-item version (WCPA-17) were used to assess IADL. A MANCOVA analyzed the effect of MoCA group on the performance-based IADL assessments while controlling for education. Results: The MANCOVA was statistically significant, F(4, 508) = 16.445, p < .001; Wilks’ λ = .784; ηp2 = .115. Follow-up univariate ANCOVAs showed that PCST Total Cues adjusted mean score (F(2, 255) = 20.006, p < .001; ηp2 = .136) and WCPA-17 Accuracy adjusted mean scores (F(2, 255) = 23.216, p < .001; ηp2 = .154) were significantly different among MoCA groups, with medium-large effect sizes. Conclusions: The tripartite group categorization of the MoCA largely parallels ability on two independent performance-based IADL assessments, a subset of individuals borderline or unimpaired on the MoCA had difficulties with complex IADL identified by performance-based IADL assessments indicating comprehensive evaluations of older adults would benefit from including both types of assessments.
Keywords: IADL, Functional cognition, Cognition, assessment, Performance-based
Received: 26 Nov 2024; Accepted: 26 May 2025.
Copyright: © 2025 Marks, Giles and Edwards. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Timothy S Marks, University of Missouri, Columbia, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.