The Computerized Functional Skills Assessment and Training Program: Sensitivity to Global Cognitive Impairment, Correlations With Cognitive Abilities, and Factor Structure

Objectives: We evaluated a novel computer-based functional skills assessment and training (CFSAT) program, which includes ecologically valid simulations of six everyday technology-related tasks. In this report, we describe the psychometric properties of the assessment in terms of sensitivity to impairment, factor structure and correlations with cognitive performance.

Design: Cross-sectional baseline assessment prior to a treatment study.

Participants: Noncognitively impaired older adults (n = 62) and cognitively impaired older adults (n = 55), that ranged in age from 60 to 86 years (M = 73.12), was primarily female (90%), and ethnically diverse (21% Hispanic, 52% African American). Participants were divided at baseline on the basis of MOCA scores and cognitive complaints.

Measurements: The Brief Assessment of Cognition (BAC), app version, was used to measure cognitive performance and completion times on the six subtasks of the CFAST constituted the functional capacity measures.

Results: Performance on the CFSAT and BAC discriminated the two cognitive status groups. All of the cognitive domains on the BAC correlated significantly with all six CFSAT subtasks (all p < .01). Factor analyses suggested that the CFSAT and the BAC loaded on separate factors and regression analyses indicated that executive functioning and processing speed had the largest independent association with performance on the CFSAT.

Conclusion: The CFSAT is sensitive to functional impairments seen in cognitively impaired older adults. Cognitive performance and CFSAT scores were related but nonredundant. Thus, the CFSAT appears to identify functional deficits that could be targeted with skills training interventions, likely augmented by pharmacological or computerized cognitive training interventions.