Relationship Between a Tripartite Classification of Mild Impairment on the Montreal Cognitive Assessment and Measures of Complex Daily Activities in Independent Community-dwelling Older Adults

Research Objectives: To compare measures of performance-based instrumental activities of daily living (IADL) among older adults according to their cognitive ability as measured by the Montreal Cognitive Assessment (MoCA). We hypothesized that performance on two separate performance-based IADL measures would be related to a recently refined tripartite grouping of MoCA unimpaired (26-30), MoCA borderline (23-25), and MoCA impaired (19-22).

Design: Cross-sectional study design.

Setting: General Community.

Participants: A convenience sample of 287 independent community-dwelling adults recruited in and around Madison, Wisconsin, aged 55-years or older, with the ability to read and write English.

Interventions: Not applicable.

Main Outcome Measures: The Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST), and the Weekly Calendar Planning Activity 17-item version (WCPA-17).

Results: There were 259 complete responses for individuals scoring 19 or above on the MoCA. A one-way multivariate analysis of variance (MANOVA) determined the effect of the tripartite cognitive status groupings derived from the MoCA on two measures of IADL performance: PCST Total Cues and WCPA-17 Accuracy. The overall MANOVA was statistically significant, F(4, 510) = 23.087, p < .001; Wilks’ λ = .717; ηp2 = .153. Follow-up univariate ANOVAs showed that both PCST Total Cues scores (F(2, 256) = 27.862, p < .001; ηp2 = .179) and WCPA-17 Accuracy scores (F(2, 256) = 36.103, p < .001; ηp2 = .220) were statistically significantly different between MoCA group categorizations.

Conclusions: The refined tripartite categorization of the MoCA parallelled ability on two independent performance-based IADL measures. This finding suggests that subtle cognitive differences ascertained by the MoCA may be at least partly reflected in the ability to perform complex daily activities. These findings should be replicated in larger studies with more diverse populations before being used in clinical practice.

Author(s) Disclosures: No conflicts of interest.