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Identifying a short functional disability screen for older persons.

D Saliba1, M Orlando, N S Wenger

  • 1Geriatric Research Education and Clinical Center, VA Greater Los Angeles Health Care System, California, USA. saliba@rand.org

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|December 29, 2000
PubMed
Summary
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Shortened lists of instrumental activities of daily living (IADLs) and activities of daily living (ADLs) can efficiently screen elders for disability. These validated item sets maintain accuracy across diverse demographic groups.

Area of Science:

  • Gerontology
  • Public Health
  • Biostatistics

Background:

  • Disability in instrumental activities of daily living (IADLs) and activities of daily living (ADLs) signals health risks in elders.
  • Screening tools may face limitations due to performance variations across age and gender.
  • Shorter screening lists could increase the adoption of IADL/ADL assessments.

Purpose of the Study:

  • To evaluate the performance of IADL/ADL items using item response theory (IRT).
  • To identify abbreviated item sets for efficient screening of IADL/ADL disability in community-dwelling elders.
  • To assess the consistency of item performance across different age and gender strata.

Main Methods:

  • Applied IRT to analyze responses from 9865 community-dwelling elders (Medicare Current Beneficiary Survey, 1993).

Related Experiment Videos

  • Assessed 11 IADL/ADL items using 'receive help/not receive help' and 'difficulty/no difficulty' response formats.
  • Conducted all-subsets analyses to identify optimal abbreviated screening lists after item performance evaluation.

    • Main Results:

    • 'Receive help' responses were consistent across age and gender groups.
    • Five items (shopping, light housework, walking, bathing, managing finances) identified 93% of individuals needing help with any IADL/ADL.
    • A distinct set of five items identified 91% of individuals reporting difficulty with any IADL or ADL.

    Conclusions:

    • The relationship between IADL/ADL items and disability is consistent across genders and age groups (younger-old vs. oldest-old).
    • Identified abbreviated lists of disability items for efficient screening of community-dwelling elders.
    • These findings support the use of shorter, validated IADL/ADL screening tools.