Cognitive Load of Activity Participation Scale (CLAP): Development and Validation

Inclusion Criteria:

• Years 1 and 2 of study:

1. Participants living in the community, aged 65 or above.

2. No vision or hearing impairment, able to communicate and read in Mandarin andTaiwanese.

3. No severe depression, or other neurological/mental disorders affectingcognitive function.

• Third year of study:

Subjective Cognitive Degeneration (SCD):

1. Participants living in the community, aged 65 or above.

2. No vision or hearing impairment, able to communicate and read in Mandarin andTaiwanese.

3. The Montreal Cognitive Assessment (MoCA) score >22

4. Use two questions to screen: "Compared with the previous situation, do you havememory problems?", "Has your family or relatives ever thought that you have memoryproblems compared with the previous situation?", the answer to both questions isyes.

5. Geriatric Depression Scale-Short Form (GDS-S) score <8

Mild Cognitive Impairment (MCI):

1. Participants living in the community, aged 65 or above.

2. No vision or hearing impairment, able to communicate and read in Mandarin andTaiwanese.

3. MCI diagnosed by neurologists or psychiatrists: the diagnosis of MCI is mainly inaccordance with the revised consensus version of the diagnostic criteria (Winblad etal., 2004), that is, memory function score is 1.5 standard deviations below thevalue for age- and education-related norms on the third edition of Wechsler MemoryScale.

4. MoCA: with a range of scores of 17-23(>17, <23) (Trzepacz et al., 2015)

5. Geriatric Depression Scale-Short Form (GDS-S) score <8

Mild Dementia:

1. Participants living in the community, aged 65 or above.

2. No vision or hearing impairment, able to communicate and read in Mandarin andTaiwanese.

3. Those who have met the diagnostic criteria for mild dementia are referred by theneurologist or psychiatrist.

Exclusion Criteria:

• Years 1 and 2 of study:

1. Have a history of diseases related to cognitive degeneration (for example:acute stroke, brain injury, unconsciousness, etc.), and those diagnosed withorganic nerve damage, brain function disorders, and related neurology.

2. People with serious mental illness or behavior problems.

• Third year of study:

SCD:

1. Cognitive changes caused by other mental, neurological diseases, or substance abuse,etc.

2. Has met the diagnostic criteria of MCI or dementia

3. Those who are unable to complete the cognitive test due to visual, auditory,physical or cognitive impairment

MCI:

1. Cognitive changes caused by other mental, neurological diseases, or substance abuse,etc.

2. Has met the diagnostic criteria for dementia.

3. Those who are unable to complete the cognitive test due to visual, auditoryimpairment

Mild Dementia:

1. Cognitive changes caused by other mental, neurological diseases, or substance abuse,etc.

2. Those who cannot accept the cognitive test because they are visually or hearingimpaired, or have serious physical disease and behavioral problems.