Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals

Age-related dysfunction of frontal systems can result in deficits in planni ng, organization, self-control, and awareness of problems, which are likely to affect the ability to care for one's self. The purpose of this study wa s to determine the relationship between age-related frontal/executive defic its and impairment in instrumental activities of daily living (IADLs) in el derly individuals. Twenty-seven community-dwelling individuals were adminis tered a comprehensive battery of neuropsychological tests and a performance -based evaluation of IADLs. Multiple regression analyses indicated that exe cutive function and depression severity accounted for a significant proport ion of variance in IADLs, with executive function making the greatest contr ibution. Tests measuring other cognitive functions, such as memory, languag e, and spatial skills, did not contribute significantly to the prediction o f functional status. Furthermore, executive measures accounted for more var iance than other demographic characteristics such as general health status, age, and educational level. The results of this study indicate that execut ive dysfunction in normal aging may be the best predictor of functional dec line. A better understanding of the mechanisms that underlie IADL skills wi ll ultimately aid in the development of compensatory and intervention strat egies designed to delay the onset of assisted living and nursing home place ment.