Computer simulations for assessing cognitively intensive instrumental activities of daily living in older adults

INTRODUCTION: Aim is to evaluate validity, reliability, diagnostic precision, and user acceptability of computer simulations of cognitively demanding tasks when administered to older adults with and without cognitive impairment. METHODS: Five simulation modules were administered to 161 individuals aged ≥60 years with no cognitive impairment (N = 81), mild cognitive impairment (N = 52), or dementia (N = 28). Groups were compared on total accuracy and time to complete the tasks (seconds). Receiver operating characteristics were evaluated. Reliability was assessed over one month. Participants rated face validity and acceptability. RESULTS: Total accuracy (P < .0001) and time (P = .0015) differed between groups. Test-retest correlations were excellent (0.79 and 0.88, respectively). Area under the curve ranged from good (0.77) to excellent (0.97). User ratings supported their face validity and acceptability. DISCUSSION: Brief computer simulations can be useful in assessing cognitive functional abilities of older adults and distinguishing varying degrees of impairment.