Validity of the medication administration test among older adults with and without dementia

Background: Impairments in everyday activities (ie, using the telephone, driving, managing medication) havebeen associated with increasing age as well as dementia severity. One of the initial functional losses among older adults both with and without dementia is impaired medication self- management skills. In fact, reduced ability to self administer medication has been identified as a significant predictor of an assisted living (AL) placement (vs an independent living [IL] placement) among older adults. We recently developed a Medication Administration Test (MAT) to aid in placement decisions regarding level of care (eg, IL, AL). Objective: The purpose of this study was to examine the construct and concurrent validity of the MAT in a sample of older adults residing in a continuing care retirement facility. Methods: IL and AL participants were administered the MAT along with a brief neuropsychological battery that included the Naturalistic Action Test, the Mini-Mental State Examination, and the Instrumental Activities of Daily Living scale. The construct validity of the MAT was assessed by correlating MAT scores with the other neuropsychological instruments of cognition and function. With respect to the MAT's concurrent validity, a discriminant function analysis was run to determine the classification accuracy (IL vs AL) of the newly developed MAT. Results: Sixty-two white participants were included in the study (mean age, 85.56 years); 34 participants were residing in an AL setting and 28 were residing in an IL setting. Evidence for construct validity was relatively robust, as performance on the MAT was moderately correlated with scores on the Mini-Mental State Examination, the Naturalistic Action Test, and the Instrumental Activities of Daily Living scale. When MAT scores were subjected to a discriminant function analysis to assess concurrent validity, MAT performance accurately classified 79.03% of the participants into the appropriate level of care (IL or AL). Conclusion: This project provides preliminary evidence for the validity of the MAT when used for placement decisions within continuing care retirement communities. Given the current need for objective measures to aid in level of care decision making, the MAT may be useful in both clinical and research arenas.