Performance-Based Assessment of Instrumental Activities of Daily Living: Validation of the Sydney Test of Activities of Daily Living in Memory Disorders (STAM)

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• 作者：Simone Reppermund ; PhD^a ; ^b ; ^{s.reppermund@unsw.edu.au} ; Rachael C. Birch ; PhD^a ; John D. Crawford ; PhD^b ; Jacqueline Wesson ; MA^c ; Brian Draper ; MD^b ; Nicole A. Kochan ; PhD^b ; Julian N. Trollor ; MD^a ; ^b ; Katharina Luttenberger ; PhD^d ; ^e ; Henry Brodaty ; MD ; DSc^b ; ^e ; Perminder S. Sachdev ; MD ; PhD^b
• 关键词：Activities of daily living ; performance test ; reliability ; dementia ; mild cognitive impairment ; IADL
• 刊名：Journal of the American Medical Directors Association
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：18
• 期：2
• 页码：117-122
• 全文大小：307 K
• 卷排序：18

文摘

The distinction between dementia and mild cognitive impairment (MCI) relies upon the evaluation of independence in instrumental activities of daily living (IADL). Self- and informant reports are prone to bias. Clinician-based performance tests are limited by long administration times, restricted access, or inadequate validation. To close this gap, we developed and validated a performance-based measure of IADL, the Sydney Test of Activities of Daily Living in Memory Disorders (STAM).DesignProspective cohort study (Sydney Memory and Ageing Study).SettingEastern Suburbs, Sydney, Australia.Participants554 community-dwelling individuals (54% female) aged 76 and older with normal cognition, MCI, or dementia.MeasurementsActivities of daily living were assessed with the STAM, administered by trained psychologists, and the informant-based Bayer-Activities of Daily Living Scale (B-ADL). Depressive symptoms were measured with the Geriatric Depression Scale (15-item version). Cognitive function was assessed with a comprehensive neuropsychological test battery. Consensus diagnoses of MCI and dementia were made independently of STAM scores.ResultsThe STAM showed high interrater reliability (r = 0.854) and test-retest reliability (r = 0.832). It discriminated significantly between the diagnostic groups of normal cognition, MCI, and dementia with areas under the curves ranging from 0.723 to 0.948. A score of 26.5 discriminated between dementia and nondementia with a sensitivity of 0.831 and a specificity of 0.864. Correlations were low with education (r = 0.230) and depressive symptoms (r = −0.179), moderate with the B-ADL (r = −0.332), and high with cognition (ranging from r = 0.511 to r = 0.594). The mean time to complete the STAM was 16 minutes.ConclusionsThe STAM has good psychometric properties. It can be used to differentiate between normal cognition, MCI, and dementia and can be a helpful tool for diagnostic classification both in clinical practice and research.