Document Type

Article

Publication Date

1-7-2026

Comments

This article is the author's final published version in JMIR Aging, Volume 9, 2026, Article Number e82092.

The published version is available at https://doi.org/10.2196/82092. Copyright © Marina Kaplan, Moira McKniff, Stephanie M Simone, Molly B Tassoni, Katherine Hackett, Sophia Holmqvist, Rachel E Mis, Kimberly Halberstadter, Riya Chaturvedi, Melissa Rosahl, Giuliana Vallecorsa, Mijiail D Serruya, Deborah A G Drabick, Takehiko Yamaguchi, Tania Giovannetti.

Abstract

BACKGROUND: Conventional methods of functional assessment include subjective self- or informant report, which may be biased by personal characteristics, cognitive abilities, and lack of standardization (eg, influence of idiosyncratic task demands). Traditional performance-based assessments offer some advantages over self- or informant reports but are time-consuming to administer and score.

OBJECTIVE: This study aims to evaluate the validity and reliability of the Virtual Kitchen Challenge-Version 2 (VKC-2), an objective, standardized, and highly efficient alternative to current functional assessments for older adults across the spectrum of cognitive aging, from preclinical to mild dementia.

METHODS: A total of 236 community-dwelling, diverse older adults completed a comprehensive neuropsychological evaluation to classify cognitive status as healthy, mild cognitive impairment, or mild dementia, after adjustment for demographic variables (age, education, sex, and estimated IQ). Participants completed 2 everyday tasks (breakfast and lunch) in a virtual kitchen (VKC-2) using a touchscreen interface to select objects and sequence steps. Automated scoring reflected completion time and performance efficiency (eg, number of screen interactions, percentage of time spent off-screen, interactions with distractor objects). Participants also completed the VKC-2 tasks using real objects (Real Kitchen). All participants and informants for 219 participants completed questionnaires regarding everyday function. A subsample of participants (n=143) performed the VKC-2 again in a second session, 4-6 weeks after the baseline, for retest analyses. Analyses evaluated construct and convergent validity, as well as retest and internal reliability, of VKC-2 automated scores.

RESULTS: A principal component analysis showed that the primary VKC-2 automated scores captured a single dimension and could be combined into a composite score reflecting task efficiency. Construct validity was supported by analyses of covariance results showing that participants with healthy cognition obtained significantly better VKC-2 scores than participants with cognitive impairment (all Ps< .001), even after controlling for demographics and general computer visuomotor dexterity. Convergent validity was supported by significant correlations between VKC-2 scores and performance on the Real Kitchen (r=-0.58 to 0.64, Ps< .001), conventional cognitive test scores (r=-0.50 to -0.22, Ps< .001), and self- and informant report questionnaires evaluating everyday function (r=0.25 to 0.43, Ps< .001). Intraclass correlation coefficients (ICCs) indicated moderate to excellent retest reliability (ICC=0.70-0.90) for VKC-2 scores after 4-6 weeks. Reliability improved in analyses including only participants who reported no change in cognitive status between time 1 and time 2 (n=123). Spearman-Brown correlations showed acceptable to good internal consistency between the VKC-2 tasks (breakfast and lunch) for all scores (0.77-0.84), supporting the use of total scores.

CONCLUSIONS: The VKC-2 is an efficient, valid, and sensitive measure of everyday function for diverse older adults and holds promise to improve the status quo of functional assessment in aging, particularly when informants are unavailable or unreliable.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

41349042

Language

English

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