Daily living can be the most challenging cognitive task of all. An activity like cooking a meal may seem simple, but it involves a wide range of intellectual and physical skills.
Loss of functionality when completing these tasks independently can be a key marker of decline in elderly patients, and as a result, many clinicians gain great value from quantifying independence when making decisions about treatment, living arrangements, or other next steps.
The IADL scale is used to assess a patient’s independent living skills and measure improvements or declines in function over time. The questionnaire asks patients or caregivers to indicate functionality in eight realms of complex everyday activities, such as using a telephone, shopping, and food preparation.
It is commonly used by occupational therapists, neurologists, elder care specialists, and researchers working with elderly patients to help determine the need for assistance, but can be used in any group where impairment may be standing in the way of everyday activities, such as rehabilitation after an injury or stroke. It is not recommended for individuals who are already living in assisted living institutions, however.
The IADL is a natural complement to the more specific but abstract areas of cognition measured by Creyos Health’s cognitive tasks. Reviews of studies using the IADL have found that deficits revealed by the questionnaire are associated with mild cognitive impairment (MCI), and that patients with MCI who exhibit IADL deficits are at a higher risk of converting to dementia (Jekel et al., 2015).
Traditional performance-based tasks designed to measure cognitive decline, such as the MoCA, are related with deficits in IADLs (Lahav & Katz, 2020). More detailed cognitive measures also predict deficits in activities of daily living (Cahn-Weiner, Boyle, & Malloy, 2010), and specific tests, such as those measuring response inhibition (measured by the Double Trouble task in Creyos Health), may be particularly predictive of IADL deficits (Jefferson et al., 2006).
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