A new, carefully validated questionnaire called Everyday Cognition can sensitively evaluate performance of everyday activities reflecting basic mental functioning when completed by someone who knows the patient well, according to an article in the July issue of Neuropsychology.

Impairments in skills such as keeping track of items at home, sorting the mail, following a conversation, shopping for a few things without a list, and finding the car in a parking lot are activities that may signal risk for disease in a patient who previously had no problems with such tasks.

Seven academic and Veterans Administration psychologists, led by co-authors Sarah Tomaszewski Farias, PhD, and Dan Mungas, PhD, of the University of California, Davis, teamed up to develop and validate the 39-question screening tool. The team first collected data on everyday functioning and mental status for 576 older adults, averaging nearly 77 years, who were evaluated at the University of California's Alzheimer's Disease Research Center. Of these individuals, 174 were diagnosed as cognitively normal, 126 were diagnosed with mild cognitive impairment, and 276 were diagnosed with dementia.

The authors also interviewed neurologists, nurses, neuropsychologists and other professionals who work with people with dementia. Building on their insights, Farias and her colleagues generated items describing everyday function in seven key cognitive domains: memory, language, factual knowledge, visual-spatial 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 for an average of nearly 45 years and were with them for an average of 75 hours per 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; nearly three in four were women.

The questionnaire 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 matched participants' medical diagnoses, a sign of external validity.

Because the questionnaire could differentiate among people with normal cognition, mild cognitive impairment, and dementia, it may become useful as a screening measure for detecting individuals at increased risk for developing dementia. An advantage is that its results do not appear to be strongly influenced by education, as is the case in other cognitive tests.