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. 2019 Jul;31(7):917-925.
doi: 10.1007/s40520-018-1034-6. Epub 2018 Sep 6.

Activities of daily living in older community-dwelling persons: a systematic review of psychometric properties of instruments

Marijke Hopman-Rock  1 , Helmi van Hirtum  2   3 , Paul de Vreede  4   5 , Ellen Freiberger  6
Affiliations

Activities of daily living in older community-dwelling persons: a systematic review of psychometric properties of instruments

Marijke Hopman-Rock et al. Aging Clin Exp Res. 2019 Jul.

Abstract

Background: Activities of daily living (ADL) are often used as predictors of health and function in older persons. This systematic review is part of a series initiated by the European Network for Action on Ageing and Physical Activity (EUNAAPA).

Aim: To assess psychometric properties of ADL instruments for use in older populations.

Methods: Electronic databases (Medline, EMBASE, AMED, Psycinfo, CINAHL) were searched, using MeSH terms and relevant keywords. Studies, published in English, were included if they evaluated one or more psychometric properties of ADL instruments in community-dwelling older persons aged 60 years and older. Combination scales with IADL were excluded. This systematic review adhered to a pre-specified protocol regarding reliability, validity, and responsiveness.

Results: In total, 140 articles describing more than 50 different ADL instruments were included. Ten instruments which were applied in minimally three different articles of good quality (clear descriptions and adequate design according to the protocol), were evaluated for reliability, validity and responsiveness; each received a summary score. The four instruments with the highest scores were the Functional Autonomy Measurement System (SMAF), 5-items Katz list (although content and wording are often inconsistent across studies), Functional Independence and Difficulty Scale (FIDS) and the Barthel Index.

Discussion: Critical reflection is essential to avoid unnecessary modifications and use of instruments that have not been documented to be valid or reliable.

Conclusion: Based on this systematic review, we recommend the SMAF, 5-item Katz, FIDS and Barthel index as ADL measures for research and care practice in older populations.

Keywords: Activities of daily living; Aging; Assessment; Community dwelling; Function; Health status.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper. The authors have also no links with the recommended ADL lists.

Figures

Fig. 1
Fig. 1
Flow chart of the selection process
See this image and copyright information in PMC

References

    1. Gill TM. Assessment of function and disability in longitudinal studies. J Am Geriatr Soc. 2010;58:S308–S312. doi: 10.1111/j.1532-5415.2010.02914.x. - DOI - PMC - PubMed
    1. Fieo RA, Austin EJ, Starr JM, Deary IJ. Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review. BMC Geriatr. 2011;11:42. doi: 10.1186/1471-2318-11-42. - DOI - PMC - PubMed
    1. McDowell I (2006) Measuring Health: A Guide to Rating Scales and Questionnaires, 3rd edn. Oxford University Press, Oxford. 10.1093/acprof:oso/9780195165678.001.0001
    1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919. doi: 10.1001/jama.1963.03060120024016. - DOI - PubMed
    1. Freiberger E, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, et al. Performance-based physical function in older community-dwelling persons: a systematic review of instruments. Age Ageing. 2012;41:712–721. doi: 10.1093/ageing/afs099. - DOI - PubMed

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