INITIAL VALIDATION of the REMOTE TELEPHONE-BASED DAILY INSTRUMENTAL ACTIVITIES of LIFE (T-DIAL) to ASSESS FUNCTIONAL CAPACITY in OLDER ADULTS

Introduction: Everyday functioning is important to assess in aging populations at risk for neurocognitive disorders. Performance-based functional assessments (PBFAs) are useful tools to characterize functional capacity, but few PBFAs can be delivered remotely and via telephone, limiting access and feasibility. The current study developed a novel PBFA administered via telephone, the Telephone-based Daily Instrumental Activities of Life (T-DIAL), and examined its expected relationships with older age, lower cognitive test scores, and poorer daily functioning. Methods: This observational, prospective study used a cross-sectional design to compare T-DIAL performance between cognitively healthy younger (i.e., ages 18-35, n=60) and older (i.e., ages 50+, n=60) adults. A total of 120 participants completed the study visit remotely via telephone. Participants completed the T-DIAL task, which utilized interactive voice response technology to simulate a bank phone menu to dispute a fraudulent charge. Participants also completed a telephone-based neuropsychological battery, two everyday functioning assessments, and questionnaires (e.g., mood). Results: Age group showed very small, non-significant relationships with T-DIAL Accuracy and Errors in logistic regression analyses controlling for phone type, mood, and phone banking frequency. T-DIAL Accuracy was significantly related to better subjective daily functioning at a medium effect size in a linear regression controlling for mood. A correlational analysis identified faster T-DIAL Completion Time was significantly, moderately related to better PBFA performance. Logistic regression analyses controlling for mood, sex, and phone banking frequency identified significant, moderate influence of global cognition and executive functions on T-DIAL Accuracy. Conclusions: Overall, this study provided mixed support for the hypotheses. Older age did not appear to influence T-DIAL performance, but factors such as better objective and subjective functioning, and higher global cognitive and executive functions appeared to contribute to better T-DIAL performance. Thus, the T-DIAL shows initial promise as an ecologically valid, telephone-based assessment of everyday functioning for financial tasks. Future studies may further T-DIAL development to increase task complexity and examine performance in longitudinal clinical samples to help determine whether this is an effective tool to characterize early functional declines in aging populations.

Author dc:creator

• Kamar, Jennifer Lindsay Thompson

Contributors dc:contributor

• Woods, Steven P
• Medina, Luis D
• Yoshida, Hanako
• Podell, Kenneth
• Webber, Troy A

• Teleneuropsychology
• Cognitive aging
• Neuropsychological Assessment
• Functional capacity
• Geropsychology
• Telepsychology

Language dc:language

en

Handle dc:identifier.uri

https://hdl.handle.net/10657/17621

OAI identifier oai:identifier

oai:tdl-ir.tdl.org:10657/17621