Can Performance on Daily Activities Discriminate Between Older Adults with Normal Cognitive Function and Those with Mild Cognitive Impairment?

Objectives To examine whether preclinical disability in performance of cognitively focused instrumental activity of daily living (C‐IADL) tasks can discriminate between older adults with normal cognitive function and those with mild cognitive impairment (MCI) and, secondarily, to determine the two tasks with the strongest psychometric properties and assess their discriminative ability so as to generate diagnosis‐relevant information about cognitive changes associated with MCI and mild neurocognitive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Design Secondary analyses of cross‐sectional data from a cohort of individuals diagnosed with normal cognitive function or MCI. Setting Pittsburgh, Pennsylvania. Participants Older adults with remitted major depression (N = 157). Measurements Diagnosis of cognitive status was made at the Alzheimer's Disease Research Center, University of Pittsburgh. Performance on eight C‐IADLs was measured using the criterion‐referenced, observation‐based Performance Assessment of Self‐Care Skills (PASS). Results Ninety‐six older adults with normal cognitive function (mean age 72.5 ± 5.9) and 61 with MCI (mean age 75.5 ± 6.3) participated. The eight C‐IADLs demonstrated 81% accuracy in discriminating cognitive status (area under the receiver operating characteristic curve (AUC) = 0.81, P