Cognitive initiation and depression as predictors of future instrumental activities of daily living among older medical rehabilitation patients.

This study investigated relationships among depressive symptoms, cognitive initiation, and instrumental activities of daily living (IADL) in 128 older African American medical rehabilitation patients. Participants were administered the Geriatric Depression Scale and measures of cognitive initiation Initiation/Perseveration subtest of the Dementia Rating Scale and verbal fluency (Controlled Oral Word Association Test letter C and Animal Naming)--at hospital discharge. Cognitive initiation predicted IADL 3 and 6 months after hospital discharge, independently of baseline IADL. While depression was related to current IADL, it did not independently predict future IADL. Results suggest that executive dysfunction,specifically cognitive initiation, is a key predictor of future IADL.