Association Between 2 Measures of Cognitive Instrumental Activities of Daily Living and Their Relation to the Montreal Cognitive Assessment in Persons With Stroke

摘要

Abstract Objectives To explore the relation between a computer adaptive functional cognitive questionnaire and a performance-based measure of cognitive instrumental activities of daily living (C-IADL) and to determine whether the Montreal Cognitive Assessment (MoCA) at admission can identify those with C-IADL difficulties at discharge. Design Prospective cohort study. Setting Acute inpatient rehabilitation unit of an academic medical center. Participants Inpatients (N=148) with a diagnosis of stroke (mean age, 68y; median, 13d poststroke) who had mild cognitive and neurological deficits. Interventions Not applicable. Main Outcome Measures Admission cognitive status was assessed by the MoCA. C-IADL at discharge was assessed by the Executive Function Performance Test (EFPT) bill paying task and Activity Measure of Post-Acute Care (AM-PAC) Applied Cognition scale. Results Greater cognitive impairment on the MoCA was associated with more assistance on the EFPT bill paying task (ρ=?.63; P P Conclusions Questionnaire and performance-based methods of assessment appear to yield different estimates of C-IADL. Low MoCA scores ( Highlights ? Persons with stroke and Montreal Cognitive Assessment scores ? C-IADL should be screened in patients with stroke who have mild or no cognitive impairments on the Montreal Cognitive Assessment. ? The Executive Function Performance Test bill paying task appears to be a good candidate for screening C-IADL in an inpatient rehabilitation setting. ? Performance-based and questionnaire methods of assessing C-IADL provide different estimates of C-IADL. ]]>