Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

Abstract

Introduction: The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults' ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions, and the underlying constructs of UFOV performance remain a topic of debate.

Method: We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We then explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study.

Results: In the four subtest variant of UFOV, only Subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV Subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general nonspeeded cognition, and visual function; the omission of Subtests 1 and 4 from the test score did not affect these associations.

Conclusions: UFOV Subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future research should investigate whether shortening UFOV by omitting these subtests is a reliable and valid assessment approach.

Keywords: Useful field of view; cognition; everyday tasks; functional performance; instrumental activities of daily living.

Figure 1

Illustration of the UFOV procedure. The stimulus displays for subtests 1-4 are shown in the box at the top. The subtests are designed to assess visual processing speed under conditions of focused attention (subtest 1), divided attention (subtest 2), and selective attention tasks (subtests 3 and 4). Presentation times vary between 16.67 ms and 500 ms in steps of 16.67 ms (1 frame on a 60 Hz computer screen). In subtests 1-3 participants give a non-speeded response identifying the briefly presented object in the center as either car or truck; in subtest 4 participants determine whether the two objects in the center are identical or different. For subtests 2-4, following the identification task, participants indicate at which location the peripheral car was displayed. A trial is marked as correct if both responses are correct; response times are not recorded. Dashed lines indicate trial elements with variable duration.

Figure 2

Violinplots of measures in the SKILL (top row) and ACTIVE studies (bottom row). UFOV scores are the display presentation time at which test takers achieves an accuracy of 75%. Timed IADL scores are the mean of z-standardized response times on all five tasks penalized for errors. The black lines represent Tukey boxplots giving median, interquartile range (IQR), and most extreme values within 1.5 IQR of the upper and lower quartile. Grey planes represent kernel densities of each distribution. UFOV = Useful Field of View; Timed IADL = Timed Instrumental Activities of Daily Living; OTDL = Observed Tasks of Daily Living; EPT = Everyday Problems Test.