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Existing cognitive screening tools often lack ecological validity or require extensive administration. Dual\u2010task paradigms combining cognitive and motor demands may provide a practical and sensitive alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to validate two dual\u2010task measures integrating cognition and hand function as cognitive screening tools for older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 103 community\u2010dwelling older adults (\u2265\u200960\u2009years) were recruited and categorized into cognitively healthy (CH,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961) and cognitively impaired (CI,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200942) groups based on Montreal Cognitive Assessment (MoCA) scores. Two dual tasks were proposed: (1) Serial Sevens Test with the Box and Block Test (SST\u2010BBT) and (2) Frequency Discrimination with the Box and Block Test (FD\u2010BBT). Construct validity was examined using known\u2010groups comparisons and receiver operating characteristic (ROC) analyses. Criterion\u2010related validity was assessed via correlations with the Mini\u2010Mental State Examination, MoCA, Stroop Color and Word Test, and Lawton Instrumental Activities of Daily Living scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After controlling for age as a covariate, the SST\u2010BBT dual task significantly differentiated CH and CI groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with an area under the ROC curve (AUC) of 0.768 (95% CI: 0.675\u20130.862). The FD\u2010BBT dual task also showed group differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) but demonstrated lower sensitivity and specificity (AUC\u2009=\u20090.713, 95% CI: 0.610\u20130.815). When applying the established dual\u2010task cutoffs, the SST\u2010BBT successfully discriminated performance across all criterion measures independent of age (\n                      <jats:italic>F<\/jats:italic>\n                      s &gt;\u20094.15,\n                      <jats:italic>p<\/jats:italic>\n                      s &lt;\u20090.045, partial &gt;\u20090.039), whereas the FD\u2010BBT failed to discriminate executive function. Both dual\u2010task measures demonstrated fair\u2010to\u2010good correlations with established cognitive and functional assessments (\n                      <jats:italic>r<\/jats:italic>\n                      s\u2009=\u20090.356\u20130.551), supporting their criterion\u2010related validity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SST\u2010BBT dual task demonstrated acceptable validity, sensitivity, and ecological relevance, supporting its potential as a practical screening tool for detecting CI in older adults. Future studies should replicate these findings in larger, more diverse samples and examine longitudinal outcomes to establish predictive validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov identifier: NCT0468977.6\n                    <\/jats:title>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70864","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:26:12Z","timestamp":1791861972000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validity of Cognitive Performance\u2010Based Screening Tools for Older Adults: Dual Tasks Combining Cognition and Hand Function"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0900-8717","authenticated-orcid":false,"given":"I\u2010Chen","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Ching","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Neurology Linkou Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3733-6638","authenticated-orcid":false,"given":"Chih\u2010Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Program in Occupational Therapy, School of Medicine Washington University  St. Louis Missouri USA"},{"name":"Department of Medicine, School of Medicine Washington University  St. Louis Missouri USA"},{"name":"Department of Orthopaedic Surgery, School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Kuang","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation Linkou Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Center of Comprehensive Sports Medicine Taoyuan Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4726-2916","authenticated-orcid":false,"given":"Ching\u2010Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation Linkou Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"Healthy Aging Research Center Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617717000546"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010015\u20100099\u20100"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2612"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.05.024"},{"key":"e_1_2_10_6_1","first-page":"165","volume-title":"Handbook of Clinical Neurology","author":"Badre D.","year":"2019"},{"key":"e_1_2_10_7_1","first-page":"149","volume-title":"Handbook of Clinical Neurology","author":"Cohen R. 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