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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