Instrumental activities of daily living scale for dementia screening in elderly people

Objective: To develop and validate an Instrumental Activities of Daily Living Scale for elderly people (IADL-E) to use in conjunction with cognitive screening tests for dementia in an educationally and socioculturally heterogeneous population.Method: Eleven IADL items were selected and weighted for major factors causing heterogeneity in the population – gender, education, social (rural/urban) setting and age. Each item was rated for its applicability (yes/no), degree of disability (scored from 0 to 2) and causative impairment (cognitive and/or physical). From this a composite index of cognitive (CDI) or physical (PDI) disability was derived. Validation was performed retrospectively on 240 subjects: 135 without and 105 with dementia by DSM-IV.Results: The IADL-E had a high internal consistency (α=0.95). The area under the receiver operating characteristic (ROC) curve was 0.97 (CI=0.94−0.99). A cutoff score of 16 on CDI provided a sensitivity of 0.91, specificity 0.99 and positive predictive value 0.76 (at 5% base rate). IADL-E correlated highly with clinical (DSM-IV, κ=0.89), functional (CDR, 0.82) and cognitive (Mini-mental Status Examination, MMSE, 0.74) diagnoses. It showed good responsiveness, with the change on CDI over a median of 23 months correlating significantly with that on MMSE (coefficient=−0.382, CI=−0.667 to −0.098; p=0.009). Individual items had good interrater and test–retest reliability.Conclusions: The IADL-E is a reliable, sensitive and responsive scale of functional abilities useful in dementia screening in a socioculturally heterogeneous population.

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Mild cognitive impairment in the elderly Relationship between communication and functional capacity

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-020009 ◽

2018 ◽

Vol 12 (2) ◽

pp. 165-172 ◽

Cited By ~ 1

Author(s):

Ana Iza Gomes da Penha Sobral ◽

Cláudia Marina Tavares de Araújo ◽

Marcos Felipe Falcão Sobral

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Activities Of Daily Living ◽

Elderly People ◽

Communication Skills ◽

Social Communication ◽

Daily Living ◽

The Elderly ◽

Intermediate Form ◽

Instrumental Activities

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.

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A review of instrumental ADL assessments for use with elderly people

Reviews in Clinical Gerontology ◽

10.1017/s0959259898008089 ◽

1998 ◽

Vol 8 (1) ◽

pp. 65-71 ◽

Cited By ~ 27

Author(s):

Gillian Ward ◽

Carol Jagger ◽

William Harper

Keyword(s):

Activities Of Daily Living ◽

Standardized Tests ◽

Elderly People ◽

Daily Living ◽

Self Care ◽

Primary Level ◽

Instrumental Activities ◽

Hierarchical Nature ◽

The 1960S ◽

Definition Of

The concept of formal or standardized tests for assessing function came to the fore in the 1960s. Katz et al. acknowledged the hierarchical nature of activities of daily living (ADL) such as eating, continence, transferring, going to the toilet, dressing and bathing in his ’Index of ADL’ and by 1968 ‘ADL’ was an accepted Index Medicus category. The definition of instrumental activities of daily living (IADL) began in 1969 with the work of Lawton and Brody who presented two scales to assess function which recognized the different degrees of complexity required for performing functional tasks. The first scale, taking life maintenance and activities essential for self-care as the primary level, was called the Physical Self-Maintenance Scale.

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