Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET’s ability to predict IADLs assessed via three different modalities relative to traditional EF measures.

Participants (93 adults aged 60 – 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol.

The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS.

Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.

广泛的研究表明，执行功能（EF）测试可以预测日常生活的工具性活动（IADL），但仍然经常因生态有效性较差而受到批评。改良六要素测试 (MSET) 是一种纸笔测试，旨在模仿日常生活的需求，并假设这将产生更生态有效的测试。尽管 MSET 捕捉不同人群认知缺陷的能力已得到广泛验证，但对其预测日常生活功能能力的支持却褒贬不一。本研究旨在检验 MSET 预测 IADL 的能力，该能力通过相对于传统 EF 测量的三种不同方式进行评估。

参与者（93 名 60 至 85 岁的成年人）在实验室完成了 MSET、EF（Delis-Kaplan 执行功能系统；D-KEFS）的传统测量以及自我报告和基于绩效的 IADL。然后，参与者使用独立生活和执行技能每日评估 (DAILIES) 协议在家完成三周的 IADL 任务。

MSET 仅预测在家完成的 IADL，而 D-KEFS 预测所有三种模式的 IADL。此外，当相互竞争时，D-KEFS 预测以家庭为基础的 IADL会超出MSET，而 MSET 并没有做出超出 D-KEFS 的贡献。

在预测社区老年人的 IADL 方面，传统 EF 测试 (D-KEFS) 似乎优于 MSET。目前的结果反对在解决一般高功能和认知健康老年患者的功能独立性时用 MSET 取代传统措施。