Performance-Based Assessments of Functional Cognition in Adults, Part 1—Assessment Characteristics: A Systematic Review
Bibliographic record
Abstract
IMPORTANCE: Although the construct of functional cognition is central to the practice of occupational therapy, there is no consensus regarding the core characteristics of functional cognitive assessments. Thus, it is necessary to review existing performance-based assessments of functional cognition and describe their characteristics to understand how functional cognition is measured and has been conceptualized. OBJECTIVE: To identify performance-based assessments of functional cognition in adults and describe their characteristics. DATA SOURCES: A literature search was conducted in the MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Scopus databases from inception to February 2022. STUDY SELECTION AND DATA COLLECTION: We searched for performance-based assessments that involve direct observation of the performance of everyday activities to assess integrated cognitive skills, referred to as functional cognition, in adults. We used a standardized spreadsheet to extract the characteristics of the included assessments (e.g., construct originally targeted, activities and scoring metrics used). FINDINGS: We identified 25 assessments; most were originally designed for measuring executive functioning. Common instrumental activities of daily living included were cooking and meal preparation, managing finances, using the telephone, and managing medication. Performance time (time taken to complete the task) was frequently used as a scoring metric. Most assessments incorporated observable indicators of functional cognitive abilities (e.g., the task is accurately performed, the task is completed, the task is performed in an efficient and safe way). CONCLUSIONS AND RELEVANCE: The findings of this review can guide occupational therapy professionals in better understanding functional cognition by illustrating how it is conceptualized in existing assessments. Plain-Language Summary: The objective of this review was to identify and examine the characteristics of performance-based assessments that involve direct observation of the performance of everyday activities to assess integrated cognitive skills, referred to as functional cognition, in adults. We identified 25 assessments. Actual or simulated daily activities used as part of the assessments included cooking and meal preparation, managing finances, using the telephone, and managing medications. These activities are all known to be key to independent community living. Performance time and number and types of errors were frequently used as scoring metrics. Most assessments incorporated indicators of functional cognitive abilities, such as the number of completed or failed tasks or whether the tasks were efficiently performed (i.e., the use of effective strategies). These performance-based assessments provide a standardized way to measure the dynamic integration of cognitive abilities during the performance of everyday activities (i.e., functional cognition).
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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 | 0.023 | 0.124 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.017 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".