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New 'everyday cognition' scale tracks how older adults function in daily life
Date:6/30/2008

language, semantic (factual) knowledge, visuospatial abilities, planning, organization and divided attention. Through pilot studies, they narrowed an initial list of 138 items to the 39 items used in the validation study.

To validate the instrument, the new rating scales were completed by reliable informants, people who lived with or knew the patients well. They knew them on average for nearly 45 years and were with them for an average of 75 hours a week. About half the informants were spouses; 41 percent were adult children; the rest were other family members or friends. The average informant was nearly 62 years old and nearly three in four were women.

The authors relied on informants rather than patients because people with dementia lose awareness of their problems. The authors also relied on observation by informants rather than by clinicians because performance assessments, such as watching someone make a peanut-butter-and-jelly sandwich, can be artificial and time-consuming. At the same time, the authors sought to improve on previous informant-based measures, which have been unable to detect mild impairment or track change over time a "must" for progressive disorders.

The ECog was shown to be valid in several ways. First, its results appeared to measure the same things as established tests, a sign of convergent validity. Second, its results "agreed" with participants' medical diagnoses, a sign of external validity.

By differentiating among people with normal cognition, Mild Cognitive Impairment (MCI), and dementia, the ECog was sensitive to the early functional changes present in MCI. Thus, the authors believe, the ECog shows great promise as a useful screening measure for detecting individuals at increased risk for developing dementia. What's more, its results do not appear to be strongly influenced by the role of education, as is the case in other cognitive tests.

The ECog's results even differentiated between
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