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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Lifestyle-adjusted function: variation beyond BADL and IADL competencies.

Steven M Albert¹, Jane Bear-Lehman, Ann Burkhardt

¹Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. smalbert@pitt.edu

The Gerontologist

|June 10, 2009

Summary

A new lifestyle-adjusted function measure using the Activity Card Sort (ACS) shows promise for assessing older adults. It identifies functional differences even in those without basic or instrumental activities of daily living disability.

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Area of Science:

Gerontology
Rehabilitation Science
Public Health

Background:

Assessing functional status in older adults is crucial for predicting disability transitions.
Existing measures may not fully capture functional capacity in community-dwelling older adults.
The Activity Card Sort (ACS) offers a unique approach to evaluating daily activities.

Purpose of the Study:

To derive and validate a lifestyle-adjusted function measure using the ACS.
To examine the distribution and correlates of this measure in older adults at risk for disability.
To assess the utility of the measure in identifying subtle functional changes.

Main Methods:

The ACS Q-sort procedure was used with 375 older adults to categorize 39 non-basic and non-instrumental activities of daily living (ADL) tasks.
Lifestyle-adjusted function was calculated as the ratio of 'easy' to 'easy + hard + no longer performed' activities.
Statistical models controlled for sociodemographic and clinical factors to identify correlates.

Main Results:

Older adults found approximately 60% of performed activities easy, but those with basic (BADL) or instrumental (IADL) disability found only 32% easy.
Lower extremity performance and depressive symptoms were significant independent correlates of lifestyle-adjusted function.
These correlates remained significant even when excluding individuals with self-reported BADL or IADL disability.

Conclusions:

The derived lifestyle-adjusted function measure, excluding never-performed activities, offers a refined assessment of functional capacity.
This measure can differentiate competency levels among individuals without reported BADL or IADL disability.
It represents a potentially valuable tool for comprehensive functional assessment in aging populations.