A revised activities of daily living/instrumental activities of daily living instrument increases interpretive power: Theoretical application for functional tasks exercise

Fieo, Robert, Watson, Roger, Dreary, Ian J and Starr, John M (2010) A revised activities of daily living/instrumental activities of daily living instrument increases interpretive power: Theoretical application for functional tasks exercise. Gerontology, 56 5: 483-490. doi:10.1159/000271603


Author Fieo, Robert
Watson, Roger
Dreary, Ian J
Starr, John M
Title A revised activities of daily living/instrumental activities of daily living instrument increases interpretive power: Theoretical application for functional tasks exercise
Journal name Gerontology   Check publisher's open access policy
ISSN 0304-324X
1423-0003
Publication date 2010-08-01
Year available 2009
Sub-type Article (original research)
DOI 10.1159/000271603
Volume 56
Issue 5
Start page 483
End page 490
Total pages 8
Editor George Wick
Place of publication Basel, Switzerland
Publisher S Karger AG
Collection year 2010
Language eng
Subject C1
920502 Health Related to Ageing
111099 Nursing not elsewhere classified
110308 Geriatrics and Gerontology
Formatted abstract
Background: As the number of adults in older age groups expands, difficulty performing usual activities of daily life is a rising health concern. A common exercise regimen employed to attenuate functional decline and disability has been resistance strength training. However, recent evidence suggests that functional tasks exercise may be more effective in preventing disability.
Objective: Activities of Daily Living (ADL) measures are one of the most widely used tools in gerontology, and yet the full sensitivity of these instruments is often not realized. The purpose of this study is to enhance the interpretive power of ADL by formally confirming a hierarchy of decline, assessing discriminatory power, and examining option characteristic curves. Theoretically, a revised ADL instrument can improve the efficacy of functional tasks training programs.
Methods: This was a cross-sectional study that employed Item Response Theory (IRT) to interpret ADL outcomes. Participants consisted of community-dwelling older adults (n = 548, aged 79) living in Scotland.
Results: A Mokken scale with p = 0.77 was obtained, indicating good reliability, and satisfying the IRT assumption that a single unidimensional scale is present. The set H coefficient of 0.48 indicated that the scale may be ordered by decreasing difficulty, with the 'Cut your own toe-nails?' item being the most difficult and 'Tie a good knot in a piece of string?' being the least difficult. Discriminatory and option characteristic parameters revealed 'Get on a bus?' to be the task most closely related to the latent construct and that item options can be used to ascertain critical thresholds for prevention type strategies.
Conclusions: Examining parameters relating to difficulty, discriminatory power, and option characteristics facilitated the identification of ADL/Instrumental ADL items that may serve to enhance functional task training in community-dwelling older adults. These analyses demonstrated that functional tasks have differing levels of discriminatory power, and that a task's discriminatory power is likely to change with varying levels of disability. This observation reinforces the notion that exercises based on functional tasks may differ significantly in their therapeutic effect. Lastly, this study was able to highlight statistically meaningful cut-points relating to when older adults should begin 'prehabilitation' interventions.
Keyword Healthy ageing
Activities of daily living
Hierarchy
Item Response Theory
Functional tasks exercise
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 05 Mar 2010, 23:26:07 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work