Abstract
This study is a preliminary investigation of the psychometric properties of the Digital Executive Functions Test of Complex Occupations (DEFT), a tool to identify unsafe occupational performance because of executive control function deficits among older adults.
Primary Author and Speaker: Jennifer Milsovic
Contributing Authors: William Mansbach, Lynn Young, Abby Williams
Executive control functions (EFC) are a set of skills that enable people to organize, sequence, and plan tasks. In older adults, deficits in EFC may cause impaired performance in complex occupations (Mansbach & Mace, 2018). While standard and performance-based EFC assessments exist, we could find no instruments that identify specific EFC-related risk for medication management, community mobility, and financial management – 3 occupations critical to independent living. The purpose of this experimental design study is to establish acceptable reliability and validity for the Digital Executive Functions Test of Complex Occupations (DEFT) and quantify impairment levels based on cut scores for the occupations of community mobility, medication management, and financial management. Study sample included community-dwelling participants. Forty participants aged 50-90 were administered the three DEFT subtests, the BCAT® cognitive test, the VPJ® judgment test, and a test of mood functioning (BADS®, Mood-5®). Normal cognition was established by BCAT® total scores. Convergent validity was established by significant correlations between the DEFT and the VPJ® (r = .88, p <.001). Discriminant validity was established by a non-significant correlation between the DEFT and the BADS® (r =-.08). Strong inter-rater reliability was demonstrated by a Kappa value of .70. Analysis of data demonstrated good construct validity and internal reliability. Normative data was established for each of the 3 subtests. During the presentation, we will present normative and impairment scores for each DEFT subtest. While further research is needed, the DEFT shows excellent promise as an assessment to provide OT practitioners with a tool to identify clients who are at risk for decreased independence and safety in complex occupations.
Mansbach, W. E., & Mace, R. A. (2018). Predicting functional dependence in mild cognitive impairment: Differential contributions of memory and executive functions. The Gerontologist. https://doi.org/10.1093/geront/gny097
Pride, A., Kornblau, B., Oliveira, D., Mbiza, S., Keith, D., & Williams, P. (2017). Correlation between executive function and instrumental activities of daily living in older adults with mild to moderate dementia. The American Journal of Occupational Therapy, 71(4_Supplement_1). https://doi.org/10.5014/ajot.2017.71s1-po3152