Brief instrument for direct complex functionality assessment: a new ecological tool

Area of Science:

• Gerontology
• Clinical Assessment
• Instrument Development

Background:

• The Direct Assessment of Functional Status (DAFS) is validated in Brazil but is time-consuming.
• There is a growing need for brief, direct functional assessments, especially for older adults living alone.
• Existing tools may not adequately capture complex functionality in older adults.

Purpose of the Study:

• To develop and provide content validity evidence for the Brief Instrument for Direct Functionality Assessment (BIDFA).
• To create a direct, complex functionality test for older adults suitable for clinical use.

Main Methods:

• Literature review of existing functionality instruments.
• Development of seven ecological tasks for assessing complex daily activities.
• Content validity analysis by eight expert judges and pilot testing with 30 older adults.

Main Results:

• The BIDFA demonstrated strong content validity with a 96.5% agreement index.
• The final BIDFA includes six domains: semantic memory/time orientation, shopping, executive attention/math/finance, organization, planning/procedural memory, and problem-solving.
• The BIDFA yields a complex functionality score from 0 to 100 points.

Conclusions:

• The BIDFA possesses good content validity, confirmed by expert judges and older adults' ecological analysis.
• This abbreviated instrument addresses complex functionality demands in older adults.
• The BIDFA offers a wider range of scores for assessing functional status in clinical settings.