O3‐03‐01: The Relationship Between Instrumental Activities of Daily Living and Executive Function in a Memory Clinic Sample
Bibliographic record
Abstract
The goal of this work is to inform the development of cognitive rehabilitation strategies for individuals across the continuum of normal aging, mild cognitive impairment, and dementia by clarifying the relationship between daily function, cognitive impairment, and mood. Differences in samples, measures, and approaches to analysis have lead to highly variable results in previous research. This study used a clinical sample closely related to individuals who may be referred for cognitive rehabilitation, and considered three measures of executive function (Trails B, phonemic fluency, and Stroop) separately. Participants were 403 consecutive referrals to an interdisciplinary memory clinic, the Rural and Remote Memory Clinic (RRMC), who were found to have no cognitive impairment (n = 75), MCI (n = 75), dementia due to Alzheimer’s disease (AD; n = 139), or non-AD dementia (n = 114). Hierarchical regression examined whether executive function, delayed memory, depression and apathy improve prediction of function beyond differences in age, education, and global cognitive function as screened by the MMSE. The relationship between the dependent variable (function), and the independent variables (memory, executive function, depression, and apathy) was examined in each diagnostic sub-group. In the hierarchical regression analyses, memory, executive function, and apathy accounted for an additional 14.6 – 20.1% of the variance in function over and above the variance accounted for by age, education, and MMSE. Memory and function were significantly correlated for individuals diagnosed with dementia (AD: r = -0.22; non-AD: r = -.035). Executive function and function were significantly correlated only when measured by the Stroop test in the non-AD group (r = -0.32). Apathy and function were significantly correlated in the cognitively intact (r = 0.47), MCI (r = 0.30), and AD groups (r = 0.37). Depression and function were only significantly correlated in the cognitively intact group (r= 0.34). Cognitive rehabilitation strategies need to be expanded beyond memory, particularly for individuals with mild cognitive impairment. Apathy has a stronger association with daily function than low mood, and executive function as measured by the Stroop test has the strongest relationship with function in a non-AD dementia sample.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".