Development of a picture‐based tool for subjective deficits in cognition and ADLs

INTRODUCTION Traditional instruments assessing activities of daily living (ADLs) and cognitive complaints are language based and insufficiently capture technology‐based ADLs, limiting use among individuals with limited language proficiency or language impairments. We developed the picture‐based assessment of subjective deficits in cognition and ADL (Pic‐ADL) to address this gap and reflect contemporary everyday functioning. METHODS The Pic‐ADL is a picture‐based self‐report questionnaire covering cognitive and ADL complaints, including novel items on digital media. We investigated 243 healthy controls and 70 neurological patients, who completed neuropsychological testing and language‐based questionnaires for validation. RESULTS The Pic‐ADL showed high acceptability, reliability, and validity. Patients with major neurocognitive disorder (NCD) reported significantly more difficulties than patients with mild NCD and controls ( p η 2 = .49). Classification accuracy of controls/mild NCD versus major NCD was 91% (sensitivity = .83, specificity = .86). DISCUSSION The Pic‐ADL demonstrated strong psychometric properties and may be useful in settings where language‐based assessment is challenging, supporting improved NCD diagnosis. TRIAL REGISTRATION : Trial registration number: DRKS00033038 (date of registration: 27.11.2023)