The relationship of longitudinal cognitive change to self-reported IADL in a general population

Jesse S. Passler, Richard E. Kennedy, Olivio J. Clay, Michael Crowe, Virginia J. Howard, Mary Cushman, Frederick W. Unverzagt, Virginia G. Wadley

Research output: Contribution to journalArticle


This study examined the relationship between cognitive change and instrumental activities of daily living (IADL) in a large, national, population-based sample. Cognitive change was assessed via verbal fluency, word list learning (WLL), and word list delayed recall (WLD). Incident cognitive impairment was defined by change in Six-Item Screener (SIS) status over a period of 10 years. Impaired IADL was defined as self-reported difficulty or needing assistance performing any IADL at Year 10. A one-word decrease in WLL over a 10-year span increased the odds of impaired IADL by 16% (95% CI 1.08–1.24) and incident cognitive impairment increased the odds of impaired IADL by 59% (95% CI 1.36–1.85) when adjusting for demographic factors, health-related behaviors, vascular risk factors and disease, and depressive symptoms. Cognitive change most strongly predicted impairment in managing finances (OR 2.47, 95% CI 2.04–3.00) and driving (OR 2.06, 95% CI 1.73–2.44).

Original languageEnglish (US)
Pages (from-to)125-139
Number of pages15
JournalAging, Neuropsychology, and Cognition
Issue number1
StatePublished - Jan 2 2020



  • Cognitive aging
  • depression
  • instrumental activities of daily living
  • longitudinal studies
  • stroke

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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