PMID- 30630529 OWN - NLM STAT- MEDLINE DCOM- 20200330 LR - 20240408 IS - 1758-9193 (Electronic) VI - 11 IP - 1 DP - 2019 Jan 10 TI - Measuring instrumental activities of daily living in non-demented elderly: a comparison of the new performance-based Harvard Automated Phone Task with other functional assessments. PG - 4 LID - 10.1186/s13195-018-0464-x [doi] LID - 4 AB - BACKGROUND: Impairment in instrumental activities of daily living (IADL) may occur in the earliest stages of mild cognitive impairment (MCI). However, there are few reliable measures of IADL in MCI or that have a sufficient range of scores in clinically normal (CN) elderly. The objective of this pilot study was to examine the convergent validity of a phone performance-based IADL instrument, the Harvard Automated Phone Task (APT), designed to measure the earliest IADL changes in Alzheimer's disease (AD), with other sensitive performance-based and subjective measures of everyday functional capacity among CN and MCI participants. METHODS: Twenty-nine CN and 17 MCI participants were administered the Harvard APT, the computer performance-based Czaja Functional Assessment Battery (CFAB), and the AD Cooperative Study ADL prevention instrument (ADCS ADL-PI) participant and study partner versions; in addition, 52 different CN and 7 MCI participants were administered the Harvard APT and the Subjective Study Partner and Participant-reported (SSPP) IADL scale. The Harvard APT was compared with the three other IADL assessments. RESULTS: In both CN and MCI, better performance on the Harvard APT was associated with better performance on the CFAB. In CN, better performance on the Harvard APT was associated with better ADCS ADL-PI participant-reported IADL, while in MCI better performance on the Harvard APT was associated with better ADCS ADL-PI study partner-reported IADL. Furthermore, in CN better performance on the Harvard APT was associated with better SSPP-IADL participant and study partner-reported IADL. CONCLUSIONS: In this small pilot study, the Harvard APT, a brief, self-administered, objective measure of IADL performance, appears to correlate well with other sensitive measures of everyday functioning, providing good preliminary convergent validity for this new measure. Moreover, it appears to perform well across both CN and MCI participants, which suggests that it is a promising measure of early, clinically meaningful functional change. This may not be the case as suggested in our small sample for subjective IADL scales that may perform differentially depending on the reporter (self vs. study partner) across the clinical spectrum possibly due to diminishing awareness of IADL difficulties in individuals who become cognitively impaired. Secondary prevention trials in AD have a great need for such ecologically valid and reliable measures of early IADL changes. FAU - Marshall, Gad A AU - Marshall GA AUID- ORCID: 0000-0002-9096-2355 AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. gamarshall@partners.org. AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. gamarshall@partners.org. FAU - Aghjayan, Sarah L AU - Aghjayan SL AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. FAU - Dekhtyar, Maria AU - Dekhtyar M AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. FAU - Locascio, Joseph J AU - Locascio JJ AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. FAU - Jethwani, Kamal AU - Jethwani K AD - Connected Health Innovation, Partners HealthCare, Harvard Medical School, Boston, MA, 02114, USA. FAU - Amariglio, Rebecca E AU - Amariglio RE AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. FAU - Czaja, Sara J AU - Czaja SJ AD - Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, FL, 33136, USA. FAU - Loewenstein, David A AU - Loewenstein DA AD - Department of Psychiatry and Behavioral Sciences, Center on Aging, University of Miami Miller School of Medicine, Miami, FL, 33136, USA. FAU - Johnson, Keith A AU - Johnson KA AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. FAU - Sperling, Reisa A AU - Sperling RA AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. FAU - Rentz, Dorene M AU - Rentz DM AD - Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. AD - Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. LA - eng GR - UL1 TR002736/TR/NCATS NIH HHS/United States GR - R01 AG027435/AG/NIA NIH HHS/United States GR - P50 AG047266/AG/NIA NIH HHS/United States GR - P50 AG005134/AG/NIA NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20190110 PL - England TA - Alzheimers Res Ther JT - Alzheimer's research & therapy JID - 101511643 SB - IM MH - Activities of Daily Living/*psychology MH - Aged MH - Aged, 80 and over MH - Aging/*physiology/*psychology MH - Cognitive Dysfunction/diagnosis/*psychology MH - Cohort Studies MH - Female MH - Humans MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Neuropsychological Tests MH - Pilot Projects MH - Psychomotor Performance/*physiology MH - *Telephone PMC - PMC6329044 OTO - NOTNLM OT - Alzheimer's disease OT - Everyday functioning OT - Instrumental activities of daily living OT - Mild cognitive impairment OT - Performance-based OT - Validation COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The Partners Healthcare Institutional Review Board approved the study. Written informed consent was obtained from all participants prior to initiation of any study procedures in accordance with Institutional Review Board guidelines. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: Some of the authors have received research salary support from Eisai Inc. (GAM), Eli Lilly and Company (GAM, KAJ, RAS), Janssen Alzheimer Immunotherapy (DMR, GAM, KAJ, RAS), Genentech (GAM), Novartis (GAM), Avid Radiopharmaceuticals (KAJ, RAS), Navidea (KAJ), and Pfizer (KAJ). Additionally, DMR has served as a consultant for Eli Lilly, Neurotrack, Biogen, and Lundbeck Pharmaceuticals, GAM has served as a consultant for Grifols Shared Services North America, Inc. and Pifzer, KAJ has served as a consultant for Bayer, GE Healthcare, Janssen Alzheimer's Immunotherapy, Siemens Medical Solutions, Genzyme, Novartis, Biogen, Roche, ISIS Pharma, AZTherapy, GEHC, Lundberg, and Abbvie, and RAS has served as a consultant for AbbVie, Biogen, Bracket, Genentech, Lundbeck, Roche, and Sanofi. SJC and DAL have Intellectual Property for the CFAB, which is owned by the University of Miami and licensed to I-Function. SJC is also a Chief Scientific Officer of I-Function and an equity holder in I-Function. The remaining authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2019/01/12 06:00 MHDA- 2020/03/31 06:00 PMCR- 2019/01/10 CRDT- 2019/01/12 06:00 PHST- 2018/04/20 00:00 [received] PHST- 2018/12/21 00:00 [accepted] PHST- 2019/01/12 06:00 [entrez] PHST- 2019/01/12 06:00 [pubmed] PHST- 2020/03/31 06:00 [medline] PHST- 2019/01/10 00:00 [pmc-release] AID - 10.1186/s13195-018-0464-x [pii] AID - 464 [pii] AID - 10.1186/s13195-018-0464-x [doi] PST - epublish SO - Alzheimers Res Ther. 2019 Jan 10;11(1):4. doi: 10.1186/s13195-018-0464-x.