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

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          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.

          Electronic supplementary material

          The online version of this article (10.1007/s40520-018-1034-6) contains supplementary material, which is available to authorized users.

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          Most cited references18

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          Measuring Health

          Ian McDowell (2006)
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            Qualitative attributes and measurement properties of physical activity questionnaires: a checklist.

            Caroline Terwee, Henrica de Vet, Mai Chinapaw … (2010)
            The large number of available physical activity (PA) questionnaires makes it difficult to select the most appropriate questionnaire for a certain purpose. This choice is further hampered by incomplete reporting and unsatisfactory evaluation of the content and measurement properties of the questionnaires. We provide a checklist for appraising the qualitative attributes and measurement properties of PA questionnaires, as a tool for selecting the most appropriate PA questionnaire for a certain target population and purpose. The checklist is called the Quality Assessment of Physical Activity Questionnaire (QAPAQ). This review is one of a group of four reviews in this issue of Sports Medicine on the content and measurement properties of physical activity questionnaires. Part 1 of the checklist can be used to appraise the qualitative attributes of PA questionnaires, i.e. the construct to be measured by the questionnaire, the purpose and target population for which it was developed, the format, interpretability and ease of use. Part 2 of the checklist can be used to appraise the measurement properties of a PA questionnaire, i.e. reliability (parameters of measurement error and reliability coefficients), validity (face and content validity, criterion validity and construct validity) and responsiveness. The QAPAQ can be used to select the most appropriate PA questionnaire for a certain purpose, but it can also be used to design or report a study on measurement properties of PA questionnaires. Using such a checklist will contribute to improving the assessment, reporting and appraisal of the content and measurement properties of PA questionnaires.
            Article 0 comments Cited 102 times – based on 0 reviews     Review now
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              Reliability of the Barthel Index when used with older people.

              Douglas Young, Gudrun Seebass, Aruna T Bansal … (2005)
              the Barthel Index (BI) has been recommended for the functional assessment of older people but the reliability of the measure for this patient group is uncertain. To investigate this issue we undertook a systematic review to identify relevant studies from which an overview is presented. studies investigating the reliability of the BI were obtained by searching Medline, Cinahl and Embase to January 2003. Screening for potentially relevant papers and data extraction of the studies meeting the inclusion criteria were carried out independently by two researchers. the scope of the 12 studies identified included all the common clinical settings relevant to older people. No study investigated test-retest reliability. Inter-rater reliability was reported as 'fair' to 'moderate' agreement for individual BI items, and a high percentage agreement for the total BI score. However, these findings were difficult to interpret as few studies reported the prevalence of the disability categories for the study populations. There may be considerable inter-observer disagreement (95% CI of +/-4 points). There was evidence that the BI might be less reliable in patients with cognitive impairment and when scores obtained by patient interview are compared with patient testing. The role of assessor training and/or guidelines on the reliability of the BI has not been investigated. although the BI is highly recommended, there remain important uncertainties concerning its reliability when used with older people. Further studies are justified to investigate this issue.
              Article 0 comments Cited 89 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Marijke Hopman-Rock:
                ORCID: http://orcid.org/0000-0001-6373-4560
                +31(0)629404270 , m.hopman@vumc.nl
                Ellen Freiberger: +49(0)911- 5302-96162 , ellen.freiberger@fau.de
                Journal
                Journal ID (nlm-ta): Aging Clin Exp Res
                Journal ID (iso-abbrev): Aging Clin Exp Res
                Title: Aging Clinical and Experimental Research
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 1594-0667
                ISSN (Electronic): 1720-8319
                Publication date (Electronic): 6 September 2018
                Publication date PMC-release: 6 September 2018
                Publication date (Print): 2019
                Volume: 31
                Issue: 7
                Pages: 917-925
                Affiliations
                [1 ]Research center Body@Work TNO (Netherlands Organization for Applied Scientific Research) and VU University Medical Center, Van der Boechhorststraat 7, 1081 BT Leiden/Amsterdam, The Netherlands
                [2 ]ISNI 000000040459992X, GRID grid.5645.2, Department of Public Health, , Erasmus MC, University Medical Center Rotterdam, ; Rotterdam, The Netherlands
                [3 ]ISNI 0000 0001 2107 3311, GRID grid.5330.5, Institute for Biomedicine of Aging, , Friedrich-Alexander University Erlangen-Nürnberg, ; Kobergerstr. 60, 90408 Nuremberg, Germany
                [4 ]ISNI 0000 0004 0622 1269, GRID grid.415960.f, Present Address: Sint Antonius Hospital, ; Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
                [5 ]Present Address: Concreet Onderzoeken and Toepassen, Hofzicht 2, 2641 LT Pijnacker, The Netherlands
                Author information
                http://orcid.org/0000-0001-6373-4560
                Article
                Publisher ID: 1034
                DOI: 10.1007/s40520-018-1034-6
                PMC ID: 6589141
                PubMed ID: 30191453
                SO-VID: 7f5f42a4-c22c-429b-9429-dc94f116bac6
                Copyright © © The Author(s) 2018
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 2 July 2018
                Date accepted : 29 August 2018
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © Springer Nature Switzerland AG 2019

                Keywords: aging,function,health status,community dwelling,activities of daily living,assessment
                Data availability:
                Keywords: aging, function, health status, community dwelling, activities of daily living, assessment

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