Derivation and validation of a short form Nottingham extended activities of daily living (SF-NEADL) scale

The Nottingham Extended Activities of Daily Living (NEADL) assessment is commonly used in research and clinical contexts. However, there are concerns surrounding psychometric properties, and with 22-items, NEADL may be too long for clinical use at scale. We aimed to derive a psychometrically robust short form NEADL.

Data were from the Virtual International Stroke Trials Archive, including individual participant data from 3,6,12 months. Six-month data were used to evaluate NEADL reliability and validity. Corrected item-total correlations identified items for inclusion in the short form (SF-NEADL). The resulting SF-NEADL was then assessed at all time-points for reliability, structural and construct validity, including confirmatory factor analysis (CFA).

NEADL had high internal consistency, and five items with corrected item-total correlations over 0.7 were selected to create a SF-NEADL. The NEADL and SF-NEADL at 6 months had excellent reliability, and construct validity. SF-NEADL reliability and validity were stable at 3 and 12 months. CFA did not suggest unidimensionality of NEADL or SF-NEADL, but SF-NEADL achieved good fit with a two-item structure.

Reliability and validity of our SF-NEADL suggest it is a robust alternative to standard eADL assessments. Its use of fewer and more relevant items makes it suitable for use in busy healthcare settings.Implications for rehabilitationAssessment of ability in extended activities of daily living (eADL) is a fundamental part of research and clinical practice.We derived a short form of the Nottingham eADL scale, containing 5 questions about mobility and kitchen tasks, that captures functional independence in daily life as robustly as the original scale.With 5 items rather than the original 22, the SF-NEADL is easier to administer and less likely to induce participant fatigue and incomplete response, making it suitable for inclusion in a battery of tests as part of a research or clinical protocol.