P4-155 COGNITIVE AND PHYSICAL CONTRIBUTIONS TO ACTIVITIES OF DAILY LIVING Bonnie Wong 1 , Tamara Fong 2 , Daniel Habtemarium 3 , Sophia DeRooij 4 , Jane Saczynski 5 , Alden Gross 6 , Richard Jones 7 , Edward Marcantonio 8 , Sharon K. Inouye 7 , 1 Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts, United States; 2 Hebrew SeniorLife, Boston, Massachusetts, United States; 3 Aging Brain Center, Institute for Aging Research, HSL, Boston, Massachusetts, United States; 4 Academic Medical Center, Amsterdam, Netherlands; 5 UMass Medical Center, Worcester, Massachusetts, United States; 6 Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States; 7 Institute for Aging Research, Boston, Massachusetts, United States; 8 BIDMC, Brookline, Massachusetts, United States. Contact e-mail: bwong3@bidmc.harvard.edu Background: Understanding the relative contributions of cognitive or phys- ical ability for completion of a task can have profound implications for man- aging disability, predicting independence, and tailoring treatment in patients diagnosed with dementia. From a research perspective, knowing the differ- ential impact of physical and cognitive contributions to functional outcomes may have notably different implications for the impact of a particular dis- ease or for application of intervention strategies. Methods: A panel of multi-disciplinary health care providers rated the relative cognitive and physical demands of 16 activities taken from standard questionnaires of functional status (IADL, ADL, and the Medical Outcomes Study Short Form 12-item questionnaire, MOS SF-12). Convergent validity of the pan- elist’s ratings was assessed by correlating items rated as most cognitively vs. most physically demanding with performance on neuropsychological and physical measures in a cohort of healthy older adults awaiting major elective surgery. We performed these correlations using functional data from both patient and proxy reports. Results: Instrumental ADL items of managing money, self-administering medications, shopping, and using transportation were rated as having at least 1.5 times more cognitive than physical demand. Walking, transferring, completion of moderately strenuous activities, and climbing stairs were assessed as having at least 1.5 times more physical than cognitive demand. Items rated as highly cognitive and highly physi- cally demanding significantly correlated with objective measurements of neuropsychological (Pearson’s r¼0.13-0.23, P< .05) and physical (Pearson’s r¼0.15-0.46, P< .05) performance, respectively. Conclusions: By identify- ing relative cognitive and physical demands of specific functional tasks, we have provided a framework for using items from standardized functional and health status scales in potentially more sensitive way to provide optimal care in dementia populations. Table 1 Description of the sample Total sample (n ¼ 417 MCI subjects) SMC- group (n ¼ 112 MCI subjects) SMC+ group (n ¼ 305 MCI subjects) Group comparison M (SD) M (SD) M (SD) SMC- vs. SMC+ group Cohen’s d p-value Age (years) 65.6 7.93 66.3 8.70 65.4 7.63 0.11 0.341 Education (years) 12.6 2.84 12.8 2.81 12.5 2.85 0.12 0.270 MMSE-score 27.6 1.66 27.6 1.62 27.7 1.67 -0.06 0.617 CERAD Delayed Recall 5.3 2.21 5.3 2.15 5.4 2.23 -0.03 0.766 CERAD total score 73.3 10.77 73.4 10.92 73.2 10.73 0.02 0.888 MADRAS 7.93 6.34 5.13 5.01 8.95 6.47 -0.63 0.000 B-ADL-score 2.16 1.29 1.96 1.37 2.23 1.26 -0.21 0.061 Follow-up time (months) 27.6 9.85 28.5 10.50 27.3 9.61 0.12 0.304 Time to conversion (months) 19.1 7.80 20.8 7.42 18.8 7.87 0.27 0.422 n % n % n % Chi 2 p-value Female gender 170 40.8 42 37.5 128 42.0 0.68 0.411 Positive ApoE4-status 158 37.9 44 39.3 114 37.4 0.13 0.722 Conversion to AD 74 17.7 11 9.8 63 20.7 6.59 0.010 Note. P-values are derived from independent sample t-tests (2-sided) for comparison of continuous variables, and from Chi 2 -tests for categorical variables. AD ¼ Alzheimer’s Dementia, BADL ¼ Bayer-Activities of Daily Living Scale, CERAD ¼ Consortium to Establish a Registry for Alzheimer’s Disease, M ¼ Mean, MADRS ¼ Montgomery Asberg Depression Rating Scale, MMSE ¼ Mini-Mental-State-Examination, MCI ¼ Mild Cognitive Impairment, SMC- ¼ MCI patients without Subjective Memory Concerns, SMC+ ¼ MCI patients with Subjective Memory Concerns, SD ¼ Standard deviation. Table 1 Validation of self-reported cognitive and physical items, n¼300. Sum of most cognitively- demanding items Sum of most physically demanding items r P value r P value Neuropsychological test scores General cognitive performance factor 0.23 <.001 0.11 ns Trail Making Test, Part A -0.18 .001 -0.12 .033 Trail Making Test, Part B -0.17 .003 -0.16 .005 Semantic Fluency 0.13 .021 0.02 ns HVLT-R Delayed Recall 0.16 .007 0.10 ns Physical performance measures MLTA 0.09 ns 0.35 <.001 Gait speed 0.08 ns 0.46 <.001 Grip strength 0.02 ns 0.15 .023 Cognitive Items selected were Money, Meals, Medications, telephone. Physical Items selected were ADL transfers, ADL walking, SF12 climbing stairs, SF12 moderate activities. Sums of Cognitive and Physical Items: higher scores indicate higher levels of functioning; lower scores indicate de- pendence; theoretical range 0-4. r ¼ Pearson correlation coefficient. ns ¼ not significant at the .05 confidence level. HVLT-R ¼ Hopkins Verbal Learning Test – Revised. MLTA ¼ Minnesota Leisure Time Activities Questionnaire Score. Trail Making Tests: higher scores reveal greater impairment. Poster Presentations: P4 P762