Skip to main content
Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings
Meyers Primary Care Institute Publications and Presentations
  • Tamara G. Fong, Harvard Medical School
  • Lauren J. Gleason, Harvard Medical School
  • Bonnie Wong, Harvard Medical School
  • Daniel Habtemariam, Hebrew SeniorLife
  • Richard N. Jones, Hebrew SeniorLife
  • Eva M. Schmitt, Hebrew SeniorLife
  • Sophia E. de Rooij, University of Amsterdam
  • Jane S. Saczynski, University of Massachusetts Medical School
  • Alden L. Gross, Hebrew SeniorLife
  • Jonathan F. Bean, Harvard Medical School
  • Cynthia J. Brown, University of Alabama - Birmingham
  • Donna M. Fick, The Pennsylvania State University
  • Ann L. Gruber-Baldini, University of Maryland School of Medicine
  • Margaret O'Connor, Harvard Medical School
  • Patrica A. Tabloski, Boston College
  • Edward R. Marcantonio, Harvard Medical School
  • Sharon K. Inouye, Harvard Medical School
UMMS Affiliation
Meyers Primary Care Institute
Publication Date
Document Type
BACKGROUND: Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. OBJECTIVES: To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. DESIGN: Expert panel survey. SETTING: Web-based platform. PARTICIPANTS: Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers. METHODS: Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. MAIN OUTCOME MEASUREMENTS: Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. RESULTS: Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P < .05) and largely physical activities correlated with physical performance (r = 0.15-0.46, P < .05). CONCLUSIONS: Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education. Published by Elsevier Inc. All rights reserved.
DOI of Published Version
PM R. 2015 Feb 4. pii: S1934-1482(15)00050-7. doi: 10.1016/j.pmrj.2015.01.018. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Tamara G. Fong, Lauren J. Gleason, Bonnie Wong, Daniel Habtemariam, et al.. "Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings" (2015) ISSN: 1934-1482 (Linking)
Available at: