Date Presented 04/22/2023

A new cut-off score for impairment on the Menu Task identified individuals who performed poorly on the Weekly Calendar Planning Activity. The Menu Task can identify those in need of further functional cognition assessment.

Primary Author and Speaker: Timothy Marks

Additional Authors and Speakers: Muhammad AL-Heizan, Gordon Giles, Dorothy Edwards

PURPOSE: Deficits in performance of instrumental activities of daily living can go undetected when using standard cognitive screens (Jaywant, Arora, Lussier, & Toglia, 2021). Occupational therapists need a brief screening tool to identify the potential for functional cognitive deficits leading to impaired occupational performance (Giles et al., 2020). The purpose of this study was to further validate and examine the Menu Task compared to an extensive measure of functional cognition - the Weekly Calendar Planning Activity (WCPA).

DESIGN: This study utilized a cross-sectional, observational design and used convenience sampling to recruit 287 community-dwelling adults aged 55 years or older with both verbal and written understanding of the English language.

METHOD: The Menu Task and the WCPA were administered in community settings by occupational therapy graduate students. A receiver operating characteristic (ROC) curve was computed to identify a cut-off score for impairment on the Menu Task based on WCPA Accuracy and to assess sensitivity and specificity. Using this criterion on the Menu Task, the sample was dichotomized into impaired and unimpaired groups in order to examine known-group differences on WCPA scores.

RESULTS: A new cut-off score of 9 was established for the Menu Task (AUC = 0.80, sensitivity = 0.89 [95% CI, 0.73 – 0.97], specificity = 0.58 [95% CI, 0.52 – 0.64]). The impairment group identified by the Menu Task performed significantly worse (p < 0.001) on WCPA subtests than the Menu Task unimpaired group.

CONCLUSION: The ROC curve analysis results indicate that the AUC, sensitivity, and specificity of the Menu Task are acceptable, and we observed significant differences in WCPA scores between groups impaired and unimpaired on the Menu Task.

IMPACT STATEMENT: Use of the Menu Task may result in the identification of clients with functional cognition impairments who might not otherwise receive services leading to improved client outcomes.


Jaywant, A., Arora, C., Lussier, A., & Toglia, J. (2021). Impaired performance on a cognitively-based instrumental activities of daily living task, the 10-Item weekly calendar planning activity, in individuals with stroke undergoing acute inpatient rehabilitation. Frontiers in Neurology, 12.

Giles, G. M., Edwards, D. F., Baum, C., Furniss, J., Skidmore, E., Wolf, T., & Leland, N. E. (2020). Making functional cognition a professional priority. The American Journal of Occupational Therapy, 74(1), 7401090010p1-7401090010p6.