Abstract

Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning (EF) contributes significantly to functional independence, and the validity of functional status measures has been examined through its relationship to EF scores. The current study used a clinical sample of older U.S. Veterans who completed a neurocognitive evaluation (n = 266). The psychometric properties of a novel, clinician-rated Functional Status Interview (FSI) and its relationship to EF measures, including the Frontal Assessment Battery (FAB) and Trail Making Test (TMT-A and TMT-B), were explored. Two FSI factors (IADL and ADL) emerged with all items loading strongly onto the subscales as predicted. EF correlated strongly with IADL but had small to medium correlations with ADL. In regression models that controlled for sociodemographic variables, all EF measures uniquely contributed to the IADL model, but only FAB and TMT-A contributed to the model for ADL. Notably, results may have been limited by prominent floor effects on TMT-B. Overall, the FSI is a promising measure with demonstrated content validity. Thus, there is preliminary support for clinicians to incorporate multiple sources of information to rate functional status using the FSI.

摘要

自我/线人报告和基于绩效的工具通常用于测量日常生活活动 (ADL) 和工具性日常生活活动 (IADL)。很少有人关注临床医生评定的措施。执行功能 (EF) 对功能独立性有很大贡献，功能状态测量的有效性已通过其与 EF 分数的关系进行了检查。目前的研究使用了完成神经认知评估的美国老年退伍军人的临床样本（n = 266)。探索了一种新颖的、临床医生评定的功能状态访谈 (FSI) 的心理测量特性及其与 EF 测量的关系，包括正面评估电池 (FAB) 和跟踪测试 (TMT-A 和 TMT-B)。出现了两个 FSI 因素（IADL 和 ADL），所有项目都像预测的那样强烈加载到分量表上。EF 与 IADL 有很强的相关性，但与 ADL 有小到中等的相关性。在控制社会人口变量的回归模型中，所有 EF 测量值都对 IADL 模型有独特的贡献，但只有 FAB 和 TMT-A 对 ADL 模型有贡献。值得注意的是，结果可能受到 TMT-B 显着地板效应的限制。总体而言，FSI 是一个很有前途的衡量标准，具有证明的内容效度。因此，