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Related Experiment Videos

Functional performance measures: are they superior to self-assessments?

A M Myers1, P J Holliday, K A Harvey

  • 1Department of Health Studies and Gerontology, University of Waterloo, Toronto, Canada.

Journal of Gerontology
|September 1, 1993
PubMed
Summary

Performance measures of functional status are not superior to self-report questionnaires. This study found both methods had similar limitations in assessing older adults' capabilities and perceived difficulty.

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Area of Science:

  • Gerontology
  • Health Sciences
  • Rehabilitation Medicine

Background:

  • Performance measures of functional status are often presumed superior to self-report measures for clinical and research use.
  • This study challenges the assumed superiority of objective, behavioral measures over subjective self-assessments.
  • A direct comparison was made using identical rating formats for self-assessments and performance assessments.

Purpose of the Study:

  • To directly compare self-assessments and performance-based assessments of functional status in older adults.
  • To evaluate the psychometric properties and acceptability of performance measures versus self-report questionnaires.
  • To determine if performance measures offer advantages in interpretability, reproducibility, and sensitivity to change.

Main Methods:

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  • 14 performance tasks simulating functional abilities were administered to 99 community-dwelling older adults (aged 60-92).
  • Participants had previously completed a 50-item instrumental activities of daily living (IADL) questionnaire.
  • A subsample was retested at 2 weeks and reassessed at 1 year.

Main Results:

  • Only 99 out of 182 eligible subjects completed at least one performance task.
  • Task completion time did not correlate with error frequency; accuracy and difficulty ratings showed poor correspondence.
  • Good agreement between observed and perceived difficulty was found for only one-third of tasks; raters generally underestimated difficulty.

Conclusions:

  • Performance measures were not psychometrically superior, more acceptable, or easier to administer/interpret than questionnaires.
  • Neither measure type alone can distinguish motivation from capability or account for personal preferences and adaptations.
  • Further research is needed to develop comprehensive assessment tools for functional status.