Article

Difficulties with performance of functional activities may result
from cognitive and/or physical impairments. To date, there has not been a clear
delineation of the physical and cognitive demands of activities of daily living.
OBJECTIVES: To quantify the relative physical and cognitive demands required to
complete typical functional activities in older adults.
DESIGN: Expert panel
survey. SETTING: Web-based platform. PARTICIPANTS: Eleven experts from 8 academic
medical centers and 300 community-dwelling elderly adults age 70 and older
scheduled for elective noncardiac surgery from 2 academic medical centers.
METHODS: Sum scores of expert ratings were calculated and then validated against
objective data collected from a prospective longitudinal study. MAIN OUTCOME MEASUREMENTS: Correlation between expert ratings and objective neuropsychologic
tests (memory, language, complex attention) and physical measures (gait speed and
grip strength) for performance-based tasks. RESULTS: Managing money,
self-administering medications, using the telephone, and preparing meals were
rated as requiring significantly more cognitive demand, whereas walking and
transferring, moderately strenuous activities, and climbing stairs were assessed
as more physically demanding. Largely cognitive activities correlated with
objective neuropsychologic performance (r = 0.13-0.23, P < .05) and largely
physical activities correlated with physical performance (r = 0.15-0.46, P < .05). CONCLUSIONS: Quantifying the degree of cognitive and/or physical demand for
completing a specific task adds an additional dimension to standard measures of
functional assessment. This additional information may significantly influence
decisions about rehabilitation, postacute care needs, treatment plans, and
caregiver education.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
CN - Successful Aging after Elective Surgery Functional Measures Working Group

Langue : ANGLAIS