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Table 2 Mentioned factors

From: Development of a model on factors affecting instrumental activities of daily living in people with mild cognitive impairment – a Delphi study

Physical function factors

 
 

First round

Second round

%

Third round

%

% diff.

Fourth round

%

% diff.

avision / seeing functions

13

39

75

      

 vision acuity

4

6

11.5

6

11.8

0.2

   

 eye movement functions

1

0

       

ahearing functions

18

37

71.2

      

 sensory functions

2

7

13.5

7

13.7

0.3

   

 proprioceptive functions

1

6

11.5

5

9.8

−1.7

   

 touch functions

3

6

11.5

3

5.88

−5.7

   

 smell functions

1

1

1.9

      

 pain

5

19

36.5

24

47.1

10.5

   

 vestibular functions

3

8

15.4

8

15.7

0.3

   

 vestibular function of balance

1

2

3.8

      

 stability

2

3

5.8

      

abalance

20

37

71.2

      

amobility / gait functions

17

38

73.1

      

 fall risk / fall experience

2

10

19.2

16

31.4

12.1

   

 walking speed

3

4

7.7

      

cfunctional mobility (e.g. stair climbing)

4

22

42.3

32

62.7

20.4

31

79.5

−16.7

 ability to travel

3

4

7.7

      

 general physical endurance functions

16

26

50

19

37.3

−12.7

   

 aerobic capacity

1

1

1.9

      

 fatigability

3

10

19.2

7

13.7

−5.5

   

 muscle power functions (general physical strength)

15

30

57.7

33

64.7

7

   

 lower limb power (lower extremity strength)

4

2

3.8

      

 grip strength

5

7

13.5

11

21.6

8.1

   

 upper extremity strength

1

1

1.9

      

 manual dexterity (fine motor skills)

9

25

48.1

27

52.9

4.9

   

 fine motor coordination

5

12

23.1

15

29.4

6.3

   

 coordination

4

9

17.3

11

21.6

4.3

   

 control of body movement functions

1

2

3.8

      

 visuo-motor coordination capacity

1

8

15.4

16

31.4

16

13

33.3

2.0

 tremor

1

0

       

 mobility of joints functions (e.g. range of motion)

13

18

34.6

8

15.7

−18.9

6

15.4

−0.3

 mobility of the spine and cervical spine

1

0

       

 gross motor function

3

6

11.5

3

5.88

−5.7

   

 motor speed

5

11

21.2

14

27.5

6.3

   

 agility

1

0

       

 functional reach

1

4

7.7

      

 functions of the cardiovascular system

2

5

9.6

      

 cardiorespiratory reserve

1

1

1.9

      

 blood pressure

1

1

1.9

      

 cholesterol values

1

1

1.9

      

 Respiratory functions

2

2

3.8

      

Cognitive function factors

 
 

First round

Second round

%

Third round

%

% diff.

Fourth round

%

% diff.

aattention functions

23

39

78

      

 sustaining attention

9

2

4

      

 shifting attention

5

4

8

      

 dividing attention

6

7

14

10

19.6

5.6

   

 sharing attention

2

2

4

      

 processing speed functions

7

19

38

17

33.3

−4.7

   

 reaction time

2

4

8

      

aexecutive functions

24

39

78

      

 sequencing

4

2

4

      

borganization and planning

11

27

54

37

72.5

18.5

   

 cognitive / mental flexibility

7

22

44

22

43.1

−0.9

   

 insight

9

2

4

      

 judgement / decision making

5

14

28

22

43.1

15.1

25

64.1

21.0

bproblem solving / reasoning

8

27

54

36

70.6

16.6

   

 inhibition

3

2

4

      

 initiation

1

1

2

      

amemory functions

25

42

84

      

 learning

4

3

6

      

 short-term memory

5

3

6

      

 long-term memory

3

0

       

 episodic memory

3

2

4

      

 semantic memory

1

0

       

 working memory

7

9

18

18

35.3

17.3

24

61.5

26.2

 prospective memory

2

3

6

      

 retrieval and processing of memory

7

4

8

      

 language functions

13

33

66

25

49.0

−17

26

66.7

17.6

 language comprehension (written and spoken)

7

11

22

10

19.6

−2.4

   

 semantic fluency

4

1

2

      

 semantic knowledge

1

0

       

 language execution

3

1

2

      

 word finding

3

3

6

      

 calculation functions

9

4

8

      

 abstraction

1

0

       

 perceptual functions

8

12

24

7

13.7

−10.3

   

 perceptual-motor functions

1

1

2

      

 visuo-spatial functions

9

21

42

22

43.1

1.1

   

 visuo-perceptual functions

5

2

4

      

 psychomotor functions

5

6

12

6

11.8

−0.2

   

 orientation

5

11

22

17

33.3

11.3

   

 energy and drive / stamina

2

3

6

      

 metacognition

3

3

6

      

 motivation

16

29

58

28

54.9

−3.1

   

 mood

9

12

24

13

25.5

1.5

   

 alertness / vigilance

5

7

14

12

23.5

9.5

   

 awareness

1

3

6

      

 intelligence

3

1

2

      

 social cognition

8

15

30

15

29.4

−0.6

   

 emotional functions

8

13

26

10

19.6

−6.4

   

Environmental factors

 
 

First round

Second round

%

Third round

%

% diff.

Fourth round

%

% diff.

 parental beliefs

2

0

0

      

 societal attitudes

4

6

12

3

5.9

−6.1

   

 social expectations

3

5

10

3

5.9

−4.1

   

 social norms

4

11

22

3

5.9

−16.1

4

10.3

4.4

 socio-cultural factors

4

19

38

22

43.1

5.1

   

 widowed / changes in personal network

3

7

14

7

13.7

−0.3

   

 family support

3

11

22

16

31.4

9.4

   

asocial network / social environment

13

35

70

      

cnetwork / social support

11

16

32

31

60.8

28.8

29

74.4

13.6

 loneliness / isolation

5

20

40

25

49.0

9

   

 personal assistance available

3

4

8

      

 immediate family (e.g. children, siblings)

6

9

18

8

15.7

−2.3

   

 extended family (e.g. spouse)

4

6

12

3

5.9

−6.1

   

 weather

1

1

2

      

 climate

3

0

       

 extreme temperatures

1

0

       

 noise

3

3

6

      

 adequate light

1

2

4

      

 air quality / pollution

3

1

2

      

 place of residence (rural versus urban environment)

7

31

62

25

49.0

−13

   

 neighborhood

4

7

14

9

17.6

3.6

   

 age-friendliness of environment

1

8

16

11

21.6

5.6

   

 environmental demands

3

6

12

3

5.9

−6.1

   

 familiarity with environment

1

7

14

9

17.6

3.6

   

 challenging environment

3

0

       

 physical environment / living environment

6

0

       

 presence of gangs

1

0

       

 type of house / apartment

3

3

6

      

 adaptation / age-friendliness / safety of home environment

7

13

26

10

19.6

−6.4

   

 Housing / immediate home environment

9

19

38

21

41.2

3.2

   

 accessibility of the house / apartment

1

4

8

      

 living form

5

6

12

5

9.8

−2.2

   

 living with family / family nearby

3

5

10

7

13.7

3.7

   

 living situation (independent / dependent)

1

5

10

8

15.7

5.7

   

 financial situation / resources

13

32

64

21

41.2

−22.8

17

43.6

2.4

 financial resources for dental care

1

0

       

 living condition

1

0

       

 access to ICT

4

4

8

      

 products and technology for personal use in daily living

2

6

12

10

19.6

7.6

   

 communication technology

2

1

2

      

 personal devices (apps)

1

0

       

 technological aids / means

2

2

4

      

 means for physical impairments / access to assistive devices

6

16

32

14

27.5

−4.5

   

 mobility aids

2

1

2

      

 access to cognitive protheses

1

2

4

      

 access to information and use of different channels

2

1

2

      

 quality of instructions (easy to understand for MCI)

1

0

       

 access to and dependence on transportation

3

8

16

9

17.6

1.6

   

 accessibility / distance to public transport

6

16

32

15

29.4

−2.6

   

 accessibility / distance to (social) activities

4

10

20

9

17.6

−2.4

   

 accessibility / distance to facilities

7

12

24

14

27.5

3.5

   

 country of residence

1

5

10

2

3.9

−6.1

   

 insurance policy of a country

1

1

2

      

 official structured support / possibilities (e.g home care)

4

11

22

10

19.6

−2.4

   

 educational opportunity

1

2

4

      

 availability and access to health care

3

12

24

12

23.5

−0.5

   

 policy

1

2

4

      

Personal factors

 
 

First round

Second round

%

Third round

%

% diff.

Fourth round

%

% diff.

 age

8

26

52

23

45.1

−6.9

   

 sex / gender

6

13

26

11

21.6

−4.4

   

 race

1

0

       

aeducation

15

35

70

      

 professional background

2

6

12

6

11.8

−0.2

   

 professional occupation

3

2

4

      

 socio economic status

7

24

48

20

39.2

−8.8

   

 genetics (e.g. predisposition)

4

6

12

      

 body composition

2

2

4

      

 body mass index

1

2

4

      

 weight / obesity

2

1

2

      

  (physical) condition / fitness

8

25

50

28

54.9

4.9

   

 predetermined physical capacity

1

0

       

 cognitive health

1

10

20

14

27.5

7.5

   

 cognitive habits

4

7

14

6

11.8

−2.2

   

 cognitive reserve

2

9

18

10

19.6

1.6

   

 nutrition / liquid intake

4

7

14

6

11.8

−2.2

   

 nutritional state

2

2

4

      

 vitamin / vitamin deficiency

1

0

       

 sleep quality

2

12

24

12

23.5

−0.5

   

 circadian rhythm

2

1

2

      

 balance between recreation and activity

1

3

6

      

 values

2

5

10

3

5.9

−4.1

   

 beliefs

3

4

8

      

  religion / spirituality

5

5

10

2

3.9

−6.1

   

 personal attitudes

1

1

2

      

 self-concept

3

2

4

      

 self-esteem

2

2

4

      

 self-satisfaction

1

0

       

 self-efficacy

4

13

26

16

31.4

5.4

   

 perceived stress

2

2

4

      

 well-being

1

0

       

 sense of purpose in IADL tasks

2

10

20

16

31.4

11.4

   

 personality

10

22

44

20

39.2

−4.8

   

 social skills

7

8

16

10

19.6

3.6

   

 conation

2

0

       

 desire for independence

2

5

10

9

17.6

7.6

   

 behavior pattern

3

0

       

 general initiative-taking

1

2

4

      

 extraversion

2

0

       

 being open (e.g. willing to learn new things)

3

5

10

3

5.9

−4.1

   

 coping strategies

8

25

50

28

54.9

4.9

   

 frustration tolerance

1

0

       

 willing to ask for and accept someone’s help

3

8

16

13

25.5

9.5

   

 flexibility / creativity

2

1

2

      

 resilience

3

8

16

5

9.8

−6.2

   

 hobbies

2

1

2

      

 interests

4

5

10

8

15.7

5.7

   

 maintenance of habits (e.g. hobbies, interests, sexuality)

1

6

12

8

15.7

3.7

   

 personal hygiene

3

0

       

 personal habits (e.g. not have done certain IADL lifelong)

1

8

16

13

25.5

9.5

   

 personal routine

3

3

6

      

 personal (daily) structure

2

2

4

      

 physical activity (past and current)

6

15

30

15

29.4

−0.6

   

 enjoy of physical activity

2

0

       

 social activities

2

3

6

      

 moral conduct

3

0

       

 family position

2

1

2

      

  (gender) roles

4

0

       

 social integration / connectedness

8

15

30

18

35.3

5.3

   

 socio-cultural background

13

10

20

10

19.6

−0.4

   

 upbringing

3

0

       

 literacy / health literacy

1

3

6

      

 experience / biography

7

5

10

4

7.8

−2.2

   

 experience - (e.g. familiarity with certain IADL tasks)

6

10

20

21

41.2

21.2

23

59

17.8

 computer literacy

3

0

       

 physical health

6

7

14

8

15.7

1.7

   

 neurological medical conditions

3

4

8

      

 musculoskeletal medical conditions

5

3

6

      

 treatment of physical illness

1

0

       

 multimorbidity

1

3

6

      

 comorbidities

3

8

16

12

23.5

7.5

   

 disease duration

1

0

       

 frailty

5

6

12

12

23.5

11.5

   

 psychological health

8

17

34

23

45.1

11.1

   

 psychosis

2

0

       

 depression

13

17

34

20

39.2

5.2

   

 anxiety

9

4

8

      

 current medication / possible side effects

5

3

6

      

 smoking

3

1

2

      

 alcohol consumption

2

2

4

      

 addiction / substance misuse

5

2

4

      
  1. Factors mentioned in the first round, frequency, %: percent-agreement between panelists; %-diff: difference in percent-agreement between two succeeding rounds – a positive number indicates more agreement
  2. afactors included after second round
  3. bfactors included after third round
  4. cfactors included after fourth round