Psychometric properties and clinical usability of the cognition in daily life scale in patients with acquired brain injury in clinical care settings.
Anne-Fleur Domensino, Johanna Ma Visser-Meily, Jacoba M Spikman and 1 others
PMID 40986292WHAT IT FOUND
The Cognition in Daily Life scale reliably captures how brain injury affects daily functioning.
It correlates with real-world disability but not with standard quiet-room tests. Clinicians found it useful for team communication, though the 20-minute administration time and lack of digital scoring were barriers.
Key findings
01The scale showed good test-retest reliability and moderate inter-rater reliability, which improved when two clinicians' ratings were combined.
02Scores on the scale correlated moderately with the Utrecht Scale for the Evaluation of Rehabilitation (a measure of daily function) but only weakly with the Montreal Cognitive Assessment (a standard quiet-room test), confirming it measures a distinct construct.
03Clinicians reported the scale helped structure observations and aided multidisciplinary communication, but criticized the length, lack of digital scoring, and difficulty interpreting total scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used a convenience sample from inpatient and residential settings, so results may not generalize to outpatient or community-dwelling individuals. The 'Actions' subscale had a high floor effect (75.5% of patients scored zero), meaning it may not detect problems in patients with mild deficits. Responsiveness to change was only suggested in a post-hoc analysis for the medical rehabilitation subgroup; it is not yet proven that the scale can reliably measure improvement over time. No clinical cut-off scores or normative data were established, making it difficult to interpret individual scores against a standard. The study did not evaluate cross-cultural validity or the scale's performance in non-Dutch populations.
Declared interests
The study was funded by the 'Gewoon Bijzonder' Programme on behalf of the Organisation of Health Research and Development (ZonMw) in the Netherlands. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not assume the CiDL scale replaces standard cognitive testing. It correlates weakly with the MoCA because it measures a different construct: the impact of impairment on daily life, not the impairment itself. A patient can have a normal MoCA score but a high CiDL score if they struggle to compensate in real-world environments.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →