COSMIN database

Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: A systematic review and evaluation of measurement properties

Wesson, J., Clemson, L., Brodaty, H., and Reppermund, S.
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.
Neurosci Biobehav Rev
1873-7528 (Electronic); 0149-7634 (Linking)
Publication year:
Symptom status:
Cognitive/mental state
Seniors (65+)
Diseases of and symptoms related to the nervous system
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
AMPS - Assessment of Motor and Process Skills   
BEAM - Brief Everyday Activities Measure
CPT - Cognitive Performance Test
DAFA - Direct Assessment of Functional Abilities
DAFS-Modified - Modified Direct Assessment of Functional Skills
DAFS-revised - Revised Direct Assessment of Functional Skills
DOT - Day Out Task
DRUGS - Drug Regimen Unassisted Grading Scale
FCI-6 - Financial Capacity Instrument-6 items
FCI-8 - Financial Capacity Instrument-8 items
FCI-9 - Financial Capacity Instrument-9 items
Hopkins Medication Schedule
ILS - Independent Living Scales
KTA - Kitchen Task Assessment
LACLS-90 - Large Allen's Cognitive Levels Screen-90
MLAT - Multi-Level Action Test
MMAA - Medication Management Ability Assessment
NAT - Naturalistic Action Test
OTAPS - Occupational Therapy Assessment of Performance & Support
OTAS - St. George Hospital Memory Disorders Clinic Occupational Therapy Assessment Scale
OTDL - Observed Tasks of Daily Living
PASS - Performance Assessment of Self-Care Skills
TFLS - Texas Functional Living Scale
UPSA-brief - Brief University of California San Diego Performance-based Skills Assessment
UPSA - University of California San Diego Performance-based Skills Assessment