Everyday problem solving among individuals with Alzheimer's disease.

Loss of functioning on complex tasks of daily living is an early indicator of dementia. The performance of 65 older adults with mild to moderate levels of Alzheimer's disease was examined on the Everyday Problems Test for the Cognitively Challenged Elderly (EPCCE), self-report inventories of functional performance, and a broad battery of clinical and neuropsychological measures. The EPCCE was designed to assess older adults on a set of complex tasks of daily living that involved not only global cognitive processes, but also higher-order executive functions. Participants solved an average of 45% of EPCCE tasks with significant differences in scores by disease severity. Performance was significantly related to global cognitive functioning and disease severity, and in particular to executive functions. Significant additional variance was accounted for by these executive functions beyond the variance accounted for by global cognitive measures.

[1]  K. Davis,et al.  A new rating scale for Alzheimer's disease. , 1984, The American journal of psychiatry.

[2]  R. Zec,et al.  Alzheimer Disease Assessment Scale: Useful for Both Early Detection and Staging of Dementia of the Alzheimer Type , 1992, Alzheimer disease and associated disorders.

[3]  S. Willis,et al.  Everyday cognitive competence in elderly persons: conceptual issues and empirical findings. , 1996, The Gerontologist.

[4]  L. Harrell,et al.  Neuropsychologic predictors of competency in Alzheimer's disease using a rational reasons legal standard. , 1995, Archives of neurology.

[5]  K. Schaie,et al.  Everyday problem solving in older adults: observational assessment and cognitive correlates. , 1995, Psychology and aging.

[6]  R. J. Johnson,et al.  The risk of nursing home placement and subsequent death among older adults. , 1992, Journal of gerontology.

[7]  B. Reisberg,et al.  The Global Deterioration Scale for assessment of primary degenerative dementia. , 1982, The American journal of psychiatry.

[8]  R. Zec,et al.  Alzheimer Disease Assessment Scale: A Subtest Analysis , 1992, Alzheimer disease and associated disorders.

[9]  K. Davis,et al.  A longitudinal study of Alzheimer's disease: measurement, rate, and predictors of cognitive deterioration. , 1994, The American journal of psychiatry.

[10]  L. Harrell,et al.  Assessing the competency of patients with Alzheimer's disease under different legal standards. A prototype instrument. , 1995, Archives of neurology.

[11]  K. Davis,et al.  Functional Decline in Alzheimer's Disease: A Longitudinal Study , 1993, Journal of the American Geriatrics Society.

[12]  J. Wade,et al.  The clinical diagnosis of Alzheimer's disease. , 1987, Archives of neurology.

[13]  J. Fleiss,et al.  The assessment of self-care capacity in geriatric psychiatric patients by objective and subjective methods. , 1976, Journal of clinical psychology.

[14]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[15]  A. B. Ford,et al.  Health and Function in the Old and Very Old , 1988, Journal of the American Geriatrics Society.

[16]  G. Fillenbaum,et al.  Screening the Elderly , 1985, Journal of the American Geriatrics Society.

[17]  M. Lezak Neuropsychological assessment, 3rd ed. , 1995 .

[18]  P. Fuld Guaranteed Stimulus-Processing in the Evaluation of Memory and Learning , 1980, Cortex.

[19]  P N Prinz,et al.  Memory, attention, and functional status in community-residing Alzheimer type dementia patients and optimally healthy aged individuals. , 1984, Journal of gerontology.

[20]  V. Clark,et al.  Computer-aided multivariate analysis , 1991 .

[21]  R. Reitan,et al.  DIFFERENTIAL EFFECTS OF LATERALIZED BRAIN LESIONS ON THE TRAIL MAKING TEST , 1959, The Journal of nervous and mental disease.

[22]  J. Ashford,et al.  Assessing Alzheimer Severity With a Global Clinical Scale , 1992, International Psychogeriatrics.

[23]  Leonard S. Cahen,et al.  Educational Testing Service , 1970 .

[24]  D. Royall,et al.  Bedside Assessment of Executive Cognitive Impairment: The Executive Interview , 1992, Journal of the American Geriatrics Society.

[25]  M. Lawton,et al.  Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living , 1969 .

[26]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[27]  R. Reitan The relation of the trail making test to organic brain damage. , 1955, Journal of consulting psychology.

[28]  R. Mohs,et al.  The Alzheimer's Disease Assessment Scale , 1996, International Psychogeriatrics.

[29]  B Gittelman,et al.  A new scale for the assessment of functional status in Alzheimer's disease and related disorders. , 1989, Journal of gerontology.

[30]  Marjorie Lowenthal Lives In Distress , 1964 .

[31]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[32]  L. Teri,et al.  Depression, Cognition, and Functional Ability in Patients with Alzheimer's Disease , 1994, Journal of the American Geriatrics Society.

[33]  M. Lawton,et al.  Assessment of older people: self-maintaining and instrumental activities of daily living. , 1969, The Gerontologist.