The Relationship Between Neuropsychological Test Performance, Social Functioning, and Instrumental Activities of Daily Living in a Sample of Rural Older Adults

This study examined the relationship between neuropsychological functioning, activities of daily living, and social interaction in a biracial sample of 133 rural community-dwelling participants with fewer than 10 years of education, who were tested twice over 4 years as part of a normative study. Neuropsychological tests predicted self-reported IADL and social functioning at Time 1 after accounting for age, education, health, depression, and gender. Physical health and the Initiation and Perseveration subscale of the Mattis Dementia Rating Scale best predicted instrumental activities of daily living. Social functioning was best predicted by gender and delayed memory recall from the Fuld Object Memory Evaluation. Functional independence and social activities declined slightly over time for all participants, but those whose neuropsychological test scores declined significantly at Time 2 reported less independence and fewer social activities at Time 1 than those participants whose cognition remained stable. Ecological and concurrent validity of self-report measures of functional status and neuropsychological testing in predicting cognitive decline are discussed.