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Background: We evaluated the versatility of the Korean version of the University of California San Diego Performance-based Skills Assessment, Validation of Intermediate Measures version (K-UPSA-2-VIM) as a new diagnostic modality to overcome the difficulties associated with an accurate objective assessment of functional capacity for evaluating mental competency.

Methods: One hundred sixteen community-dwelling elderly individuals were enrolled. Questionnaires, including the Mini-Mental State Examination (MMSE), the clinical dementia rating (CDR), the neurocognitive battery of the Korean version of the consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K-NP), the Korean version of Instrumental Activities of Daily Living Index (K-IADL), and the K-UPSA-2-VIM, were administered. A receiver operating characteristic (ROC) curve analysis was performed to explore the discriminative potential.

Results: Seventy-eight cognitively normal (CN) participants and 38 individuals with cognitive impairment no dementia (CIND) were analyzed. The K-UPSA-2-VIM showed fair internal consistency (Cronbach alpha = 0.886). There were significant differences among groups in all subdomains (finance, communication, comprehension/planning, transportation, and household skills) of the K-UPSA-2-VIM, which were significantly correlated with CERAD-K-NP subscales. The K-UPSA-2-VIM showed high sensitivity (73.7%) and specificity (82.1%), with an area under the curve (AUC) of 0.828 (95% confidence interval: 0.747-0.909, p < 0.001) to discriminate CIND.

Conclusion: The K-UPSA-2-VIM is a reliable performance-based instrument for evaluating real-world high-functional capacity of older Korean adults in the community.