MARC

LEADER 00000nab a2200000uu 4500
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022 |a 1552-5260 
022 |a 1552-5279 
024 7 |a 10.1002/alz70857_107600  |2 doi 
035 |a 3286951693 
045 0 |b d20251201 
100 1 |a Keleman, Audrey A.  |u Washington University in St. Louis School of Medicine, St. Louis, MO, USA, 
245 1 |a Cognitive predictors of daily activity performance 
260 |b John Wiley & Sons, Inc.  |c Dec 1, 2025 
513 |a Journal Article 
520 3 |a Background This study aimed to investigate the relationship between cognition, Alzheimer's disease (AD) biomarkers, and instrumental activities of daily living (IADL) performance among cognitively normal (CN) older adults, to identify key predictors of IADL performance. A better understanding of the combined influence of cognitive function and AD pathology on IADL performance in CN older adults could lead to the development of more precise functional screening tools for preclinical AD, improved functional outcome measures for AD and aging, and the development of interventions designed to maintain or improve IADL performance. Method CN older adults (n&#xa0;=&#xa0;173) performed three IADL tasks (shopping, checkbook balancing, medication management) from the Performance Assessment of Self‐Care Skills in their home. Cognitive and AD biomarker assessments were completed in an academic medical center. Amyloid and tau positron emission tomography (PET) were used to measure AD pathology. IADL performance was transformed into one composite score and dichotomized (better vs. worse, split at median). Cognitive assessments were transformed to create composites: Global, Episodic Memory, Semantic Memory, Attention & Processing, Working Memory, and Visuospatial. Logistic regression models were used to examine cognitive and biomarker predictors of IADL performance while controlling for demographic covariates. Result Cognitive domains, particularly the Global composite (OR=0.34, p&#xa0;<&#xa0;0.001) and Attention & Processing (OR=0.40, p&#xa0;=&#xa0;0.001), emerged as strong predictors of IADL performance. Higher amyloid burden (OR=1.82, p&#xa0;=&#xa0;0.015) was associated with worse IADL performance and tauopathy (OR=1.61, p&#xa0;=&#xa0;0.060) demonstrated a trend toward association. Comparison of predictive models identified additive influences of cognition and amyloid in predicting IADL performance. Conclusion These findings suggest that cognitive function, particularly Global and Attention & Processing domains, and AD pathological burden play significant, complementary roles in IADL performance among CN older adults. Findings may be used to inform the development of sensitive functional assessments in preclinical AD that focus on key deficits, and later to develop interventions targeting important modifiable factors and compensatory rehabilitative methods to improve IADL performance in everyday life. 
653 |a Cognitive functioning 
653 |a Episodic memory 
653 |a Intervention 
653 |a Semantic memory 
653 |a Alzheimer's disease 
653 |a Shopping 
653 |a Memory 
653 |a Prediction models 
653 |a Everyday life 
653 |a Older people 
653 |a Task performance 
653 |a Cognition 
653 |a Self evaluation 
653 |a Activities of daily living 
653 |a Cognitive ability 
653 |a Cognition & reasoning 
653 |a Cognitive aspects 
653 |a Neuroimaging 
653 |a Biological markers 
653 |a Attention 
653 |a Semantic processing 
653 |a Short term memory 
653 |a Evaluation 
653 |a Visual memory 
653 |a Spatial memory 
653 |a Pathology 
653 |a Tomography 
653 |a Self care 
653 |a Aging 
653 |a Drugs 
653 |a Adults 
653 |a Positron emission tomography (PET) 
653 |a Medical screening 
653 |a Biomarkers 
653 |a Positron emission tomography 
700 1 |a Weakley, Alyssa  |u University of California, Davis School of Medicine, Sacramento, CA, USA, 
700 1 |a Bollinger, Rebecca M.  |u Washington University in St. Louis School of Medicine, St. Louis, MO, USA, 
700 1 |a Foster, Erin  |u Washington University in St. Louis, St. Louis, MO, USA, 
700 1 |a McKay, Nicole S.  |u Washington University in St. Louis, School of Medicine, St. Louis, MO, USA, 
700 1 |a Millar, Peter R  |u Washington University School of Medicine, St. Louis, MO, USA, 
700 1 |a Hassenstab, Jason J.  |u Washington University in St. Louis, School of Medicine, St. Louis, MO, USA, 
700 1 |a Benzinger, Tammie L.S.  |u Washington University in St. Louis School of Medicine, St. Louis, MO, USA, 
700 1 |a Morris, John C.  |u Washington University in St. Louis, School of Medicine, St. Louis, MO, USA, 
700 1 |a Ances, Beau  |u Washington University in St. Louis School of Medicine, St. Louis, MO, USA, 
700 1 |a Stark, Susan L.  |u Washington University in St. Louis School of Medicine, St. Louis, MO, USA, 
773 0 |t Alzheimer's & Dementia  |g vol. 21 (Dec 1, 2025) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3286951693/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3286951693/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch