Date of Award

1-1-1998

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Master of Psychology

Faculty

Faculty of Community Services, Education and Social Sciences

First Supervisor

Associate Professor Ed Helmes

Abstract

This exploratory research investigated the relationship between a brief neuropsychological measure and everyday functional ability in older community dwelling adults. The association between these two areas is complex, as a specific functional domain often involves several of the cognitive skills typically assessed by a neuropsychological instrument. Whilst there is an extensive literature linking neuropyschological tests to everyday functioning in cognitively impaired older adults, little research has been directed at investigating the relationship between cognitive test performance and everyday competence in non-dementing older people who reside independently in the community. A brief cognitive instrument able to predict coping deficits in instrumental activities of daily living would facilitate identification of health care and service needs, contributing to the functional independence of this population. A sample of 134 independently-living males and females aged 60-93 years completed the Neurobehavioural Cognitive Status Examination (Cognistat) and the Direct Assessment of Functional Status (DAFS). As beliefs about performance have been shown to correlate with actual ability, study participants also completed a 72-question self-efficacy inventory, the Personality in Intellectual-Aging Contexts (PIC). Finally, in order to investigate the relationship of health and functional performance, participants responded to a four-item subjective health measure. Simple correlations revealed modestly significant relationships between subjective health and two of the functional domains. Although there were exceptions, the general pattern was for significant correlations between self-efficacy sub-scales and measures of everyday competence. This pattern was also evident in the correlations between the cognitive variables and the functional domains. Hierarchical regression analyses examined the relative ability of self-reported health, self-efficacy scales from the PIC and the cognitive variables from Cognistat to predict the functional domains of DAFS, in that order. Self-reported health accounted for comparatively little variance in all domains of DAFS. The PIC inventory contributed significantly to the variance of four of the five functional domains, exceeding the contribution of the cognitive variables in two areas. Cognistat scales explained a significant amount of the variance in all DAFS domains, retaining the highest predicted amount in three instances. In summary, when self-reported health and self-efficacy were statistically controlled, cognitive variables remained strong predictors of everyday competence. Memory was identified as the most consistent predictor of everyday task performance. It was argued that components of memory functioning may also be strongly associated with deficits in other cognitive variables. A brief cognitive measure predicting the functional ability of an older independently-living adult may be more practical and cost-effective than a functional assessment. It was therefore concluded that interventions aimed at improving cognitive functioning, in particular memory, may have positive implications for performance in several functional domains.

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