Assessing functional performance using computer-based simulations of everyday activities

Current functional capacity (FC) measures for patients with schizophrenia typically involve informant assessments or are in paper and pencil format, requiring in-person administration by a skilled assessor. This approach presents logistic problems and limits the possibilities for remote assessment, an important issue for these patients. This study evaluated the feasibility of using a computer-based assessment battery, including simulations of everyday activities. The battery was compared to in-person standard assessments of cognition and FC with respect to baseline convergence and sensitivity to group differences. The battery, administered on a touch screen computer, included measures of critical everyday activities, including: ATM Banking/Financial Management, Prescriptions Refill via Telephone/Voice Menu System, and Forms Completion (simulating a clinic and patient history form). The sample included 77 older adult patients with schizophrenia and 24 older adult healthy controls that were administered the battery at two time points. The results indicated that the battery was sensitive to group differences in FC. Performance on the battery was also moderately correlated with standard measures of cognitive abilities and showed convergence with standard measures of FC, while demonstrating good test-retest reliability. Our results show that it is feasible to use technology-based assessment protocols with older adults and patients with schizophrenia. The battery overcomes logistic constraints associated with current FC assessment protocols as the battery is computer-based, can be delivered remotely and does not require a healthcare professional for administration.