Australian modified Lawton's Instrumental Activities of Daily Living Scale contributes to diagnosing older adults with cognitive impairment

Abstract

Objective To assess the ability of the Australian Modified Lawton's Instrumental Activities of Daily Living (IADL) Scale (Modified Lawton's Scale) to screen for cognitive impairment in patients without physical or sensory deficits. Methods Prospective single‐blind study of diagnostic accuracy. Results Data were available for 249 patients. At ≤25 points on the Modified Lawton's Scale, the area under the receiver operating characteristic curve (AUC) for patients with dementia was 0.90 (95% CI 0.83, 0.96), with sensitivity of 95% and specificity of 84%. The scale had decreased ability to identify patients with mild cognitive impairment (MCI) with the AUC highest at 0.76 (95% CI 0.67, 0.84), with a sensitivity of 77% and specificity of 74% at ≤26 points. The Modified Lawton's Scale had a significant strong correlation with the Mini‐Mental State Examination (0.73) (P ≤ 0.001). Conclusion A score of ≤25 on the Modified Lawton's Scale may indicate cognitive impairment impacting on IADL.

Management of Acute Cerebral Infarction by Intravenous Thrombolysis with Recombinant T Cell Receptor and Plasminogen Activator and Association of Emergency Nursing Route in the Prognosis

“…Patients with a primary intracranial artery occlusion almost never have a National Institutes of Health Functional Status Scale (NIHSS) score under 10. There is only a little amount of accuracy in making a clinical diagnosis of vascular territory (carotid versus vertebrobasilar) (20).…”

Stroke survivors’ occupational performance and cognitive strategy use: A pilot exploration of strengths and difficulties using the Perceive Recall Plan Perform System of Task Analysis

“…Literature indicates that training and resourcing increases the implementation of standardised ecological assessments (Burns and Neville, 2016;Sansonetti and Hoffman, 2013). Whilst the PRPP differs significantly to the AMPS in its theoretical basis, focus on cognition, clinical utility (Stigen et al, 2019) and its combined approach to occupational performance, real-world congitive strategy application and individidualised intervention (Chapparo and Ranka, 2012;Sansonetti and Hoffman, 2013), the PRPP and AMPS are the most common standardised ecological assessments used by occupational therapists (Sansonetti and Hoffman, 2013) and both require training in their use (Harper et al, 2019;Sansonetti and Hoffman, 2013). Further studies should investigate the application of the AMPS in ESD and compare PRPP to AMPS, alongside other measures.…”

“…Daily Living scale: this scale assesses occupational performance in community living across eight IADL activities (telephone use, shopping, food preparation, housekeeping, laundry, transport, medication management and financial management). Each activity is rated on an ordinal scale of what the individual could do, to a maximum score of 30, with higher scores representing greater independence (Harper et al, 2019).…”

“…Literature recommends further research of poststroke cognition and standardised ecological-based assessments of cognition (McDonald et al, 2019;Pilegaard et al, 2014;Sansonetti and Hoffman, 2013) such as the PRPP. In Australia, ESD is commonly a transitional service and, for benchmarking, this particular service routinely collected global measures of occupational performance using the Functional Independence Measure (FIM) to assess ADL and the Australian modified Lawton's Instrumental Activities of Daily Living scale (Lawton's) to measure IADL (Australian Rehabilitation Outcomes Centre, 2018; Harper et al, 2019). Whilst effective ADL and IADL performance is associated with cognition (Pilegaard et al, 2014), these tools alone do not evaluate the interplay between cognitive strategy application, occupational performance and the environment, nor do they support individualised intervention to optimise occupational performance.…”