Intrinsic Capacity: Validation of a New WHO Concept for Healthy Ageing in a Longitudinal Chinese Study

2021 ◽  
Author(s):  
John R Beard ◽  
Yafei Si ◽  
Zhixin Liu ◽  
Lynn Chenoweth ◽  
Katja Hanewald
Keyword(s):  
Construct Validity ◽  
Activities Of Daily Living ◽  
Sex Education ◽  
Daily Living ◽  
Structural Equation ◽  
World Health ◽  
General Factor ◽  
Personal Factors ◽  
Chinese Study ◽  
Intrinsic Capacity

Abstract Background The World Health Organization has proposed a model of healthy aging built around the concept of functional ability, comprising an individual’s intrinsic capacity, the physical and social environment they occupy, and interactions between the two. However, these constructs have been poorly defined. We examined the structure of intrinsic capacity in a representative sample of the Chinese population aged 60 years and over and assessed its value in predicting declining performance in instrumental activities of daily living (IADLs) and activities of daily living (ADLs) using similar methods to a construct validation previously undertaken in an English cohort. Methods De-identified data were accessed on 7643 participants of the China Health and Retirement Longitudinal Study (CHARLS) 2011 and 2013 waves. Incrementally related structural equation modelling was applied, including exploratory and confirmatory factor analysis, and path analysis. Multiple linear regression tested construct validity, and simple and serial mediation models assessed predictive validity. Results Factor loadings for the models showed a clear structure for intrinsic capacity: one general factor with five subfactors - locomotor, cognitive, psychological and sensory capacities, and vitality (reflecting underlying physiologic changes). Intrinsic capacity predicted declining performance in both IADLs (Standardized Coefficient (SE) -0.324 (0.02), p<0.001) and ADLs (-0.227 (0.03), p<0.001), after accounting for age, sex, education, wealth and number of chronic diseases. Each characteristic was associated with intrinsic capacity, providing strong construct validity. Conclusions Assessment of intrinsic capacity provides valuable information on an individual’s subsequent functioning beyond that afforded by age, other personal factors and multimorbidity.

scholarly journals The structure and predictive value of intrinsic capacity in a longitudinal study of ageing

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e026119 ◽  
Author(s):  
John R Beard ◽  
A T Jotheeswaran ◽  
Matteo Cesari ◽  
Islene Araujo de Carvalho
Keyword(s):  
Factor Analysis ◽  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Structural Equation ◽  
Direct Relationship ◽  
Path Model ◽  
Future Research ◽  
General Factor ◽  
Intrinsic Capacity

ObjectivesTo assess the validity of the WHO concept of intrinsic capacity in a longitudinal study of ageing; to identify whether this overall measure disaggregated into biologically plausible and clinically useful subdomains; and to assess whether total capacity predicted subsequent care dependence.DesignStructural equation modelling of biomarkers and self-reported measures in the English Longitudinal Study of Ageing including exploratory factor analysis, exploratory bi-factor analysis and confirmatory factor analysis. Longitudinal mediation and moderation analysis of incident care dependence.SettingsCommunity, United Kingdom.Participants2560 eligible participants aged over 60 years.Main outcome measuresActivities of daily living (ADL) and instrumental activities of daily living (IADL).ResultsOne general factor (intrinsic capacity) and five subfactors emerged: locomotor, cognitive; psychological; sensory; and ‘vitality’. This structure is consistent with biological theory and the model had a good fit for the data (χ2=71.2 (df=39)). The summary score of intrinsic capacity and specific subfactors showed good construct validity. In a causal path model examining incident loss of ADL and IADL, intrinsic capacity had a direct relationship with the outcome—root mean square error of approximation (RMSEA)=0.02 (90% CI 0.001 to 0.05) and RMSEA=0.008 (90% CI0.001 to 0.03) respectively—and was a strong mediator for the effect of age, sex, wealth and education. Multimorbidity had an independent direct relationship with incident loss of ADLs but not IADLs, and also operated through intrinsic capacity. More of the indirect effect of personal characteristics on incident loss of ADLs and IADLs was mediated by intrinsic capacity than multimorbidity.ConclusionsThe WHO construct of intrinsic capacity appears to provide valuable predictive information on an individual’s subsequent functioning, even after accounting for the number of multimorbidities. The proposed general factor and subdomain structure may contribute to a transformative paradigm for future research and clinical practice.

scholarly journals PREVALENCE OF PHYSICAL DISABILITY IN SENIOR CITIZENS OF PUNJAB PROVINCE, PAKISTAN

2020 ◽  
Vol 11 (4) ◽  
pp. 16-24
Author(s):  
Hamid Mehmood ◽  
Abdul Rauf ◽  
Muhammad Yaqoob ◽  
Saleem Rana
Keyword(s):  
Activities Of Daily Living ◽  
Sex Education ◽  
Physical Disability ◽  
Daily Living ◽  
Senior Citizens ◽  
Emotional Health ◽  
Senior Citizen ◽  
Total Sample ◽  
World Health ◽  
Important Indicator

ABSTRACT BACKGROUND & OBJECTIVE: World Health Organization (WHO) considers that Activities of Daily Living (ADL) is the most important indicator to measure physical and cognitive functions in senior citizens. It is important to know the prevalence of physical disability to find out the needs of senior citizens regarding physical, mental and emotional health. This study has provided us the prevalence rate of physical disability among the senior citizen in the five major cities of Punjab, Pakistan. METHODOLOGY: This descriptive study was conducted over a period of  six months June (06, 2019 to December 05, 2019). The sample was randomly selected. The respondent were senior citizen (Male/Female) having an age of above 60 years. Data were collected from the Index cases. Questionnaire and assessment scales were used as study scale and total sample size was 3675. RESULTS: The results of study showed that the activities of daily living (ADL) and instrumental activities of daily living (IADL) are related to age, sex, education, social and psychological factors. The facilities of education, job, entertainment, social activities vary from city to city. In all cities a p =0.05 was used. In addition, an Eo= 4.5 was set and the reliability to be used was 95%. CONCLUSION: It has been concluded that the physical disability in the senior citizens is increasing due to aging population.

scholarly journals Assessment of Motor Activities of Daily Living: Spanish Cross-Cultural Adaptation, Reliability and Construct Validity of the DCDDaily-Q

2020 ◽  
Vol 17 (13) ◽  
pp. 4802 ◽  
Author(s):  
Laura Delgado-Lobete ◽  
Rebeca Montes-Montes ◽  
Berdien W. van der Linde ◽  
Marina M. Schoemaker
Keyword(s):  
Construct Validity ◽  
Activities Of Daily Living ◽  
Internal Consistency ◽  
Daily Living ◽  
Developmental Coordination Disorder ◽  
Culturally Adapted ◽  
Confirmatory Factor ◽  
Motor Activities ◽  
And Performance ◽  
Coordination Disorder

The DCDDaily-Q is an instrument that aims to comprehensively assess motor performance in a broad range of activities of daily living (ADL) and to identify risk of Developmental Coordination Disorder (DCD) in children. The aim of this study was to cross-culturally adapt the DCDDaily-Q into European Spanish (DCDDaily-Q-ES) and to test its psychometric properties in Spanish 5 to 10 year old children. The DCDDaily-Q was translated and cross-culturally adapted into Spanish following international guidelines. Two-hundred and seventy-six parents of typically developing Spanish children completed the final version of the DCDDaily-Q-ES (M = 7.5 years, SD = 1.7; girls = 50%). Confirmatory Factor Analysis (CFA), internal consistency, and corrected item-total correlations were conducted to test construct validity, internal consistency, and homogeneity of the DCDDaily-Q-ES. The DCDDaily-Q-ES achieved good semantic, conceptual, and cultural equivalence. CFA supported construct validity of the DCDDaily-Q-ES. Reliability values were also good (Cronbach’s alpha = 0.703–0.843; corrected item-total correlations = 0.262–0.567). This is the first study to cross-culturally adapt and examine the DCDDaily-Q outside the Netherlands. The findings suggest that the DCDDaily-Q-ES is a reliable and valid measure to assess learning, participation, and performance in a broad range of ADL.

Reliability and Validity of Turkish Myasthenia Gravis-Activities of Daily Living Scale

2020 ◽  
pp. 153944922096107
Author(s):  
Ecem Karanfil ◽  
Yeliz Salcı ◽  
Ayla Fil-Balkan ◽  
Can Ebru Bekircan-Kurt ◽  
Sevim Erdem Özdamar ◽  
...  
Keyword(s):  
Construct Validity ◽  
Myasthenia Gravis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Life Questionnaire ◽  
Good Test ◽  
Retest Reliability ◽  
Test Retest Reliability

Linguistic, reliable, and valid secondary efficacy measures are important in clinical settings and studies. The aim of the study is to report test–retest reliability and construct validity of Turkish version of Myasthenia Gravis-Activities of Daily Living Scale (MG-ADL-T) in Myasthenia Gravis (MG) patients. Fifty-two ocular and generalized individuals with MG, applying to rehabilitation center, were included in the study. MG-ADL-T, MG quality-of-life questionnaire (MG-QoL), MG composite (MGC), quantitative MG score (QMGS), and pulmonary function test were administered. Reliability was assessed with intraclass correlation coefficient (ICC) and Cronbach’s alpha. Spearman correlation test and receiver operating characteristic (ROC) analysis were performed for construct validity. MG-ADL-T had fair internal consistency (Cronbach’s α = .67), excellent test–retest reliability (ICC = 0.96) and moderate construct validity (MG-QoL, r = 0.59; QMGS, r = .58; MGC, r = .68). MG-ADL, a unique scale that evaluates activities of daily living (ADL), has good test–retest reliability and construct validity in Turkish MG patients.

Heterogeneous Long-Term Trajectories of Dependency in Older Adults: The PAQUID Cohort, a Population-Based Study over 22 years

2020 ◽  
Vol 75 (12) ◽  
pp. 2396-2403 ◽  
Author(s):  
Arlette Edjolo ◽  
Jean-François Dartigues ◽  
Karine Pérès ◽  
Cécile Proust-Lima
Keyword(s):  
Activities Of Daily Living ◽  
Sex Education ◽  
Successful Aging ◽  
Daily Living ◽  
Functional Decline ◽  
Population Based ◽  
Theory Model ◽  
Factors Associated ◽  
Instrumental Activities ◽  
High Dependency

Abstract Background A critical step toward successful aging is to identify opportunities for prevention of functional decline. Our aim was to describe the heterogeneity in trajectories of dependency preceding death in elders and to identify factors associated with this heterogeneity. Methods The study relied on 3,238 participants of the prospective population-based PAQUID cohort aged 65+ at baseline in 1988. Dependency was defined from an 11-item scale of basic and instrumental activities of daily living (ADL: bathing, dressing, toileting, continence, eating, and transferring; instrumental activities of daily living (IADL): telephoning, shopping, using transport, handling medication, and managing finances) collected over 22 years. Heterogeneous trajectories were estimated using a longitudinal item response theory model including latent classes. Results Five distinct profiles of functional dependency were identified over the two last decades of life: persistently high (12%), moderate (26%), persistently low (40%), and accelerated high dependency (15%), and no dependency (8%). Main factors associated with heterogeneity included age at death, sex, education, initial cognition (Mini-Mental State Examination [MMSE] score and dementia), initial disability, and poly-medication. Conclusions In the two last decades of life, more than 9 elders in 10 were characterized as functional decliners. On average, around half of the elders died with no or mild dependency, while 27% live several years with a high level of limitations and would need assistance in activities of daily living, at least for 2–4 years preceding death. The identified factors associated with these trajectories are important to understand functional heterogeneity in elders and to propose interventions to postpone or prevent “chronic” disability.

scholarly journals INTRA-INDIVIDUAL PHYSICAL AND PSYCHOLOGICAL SYMPTOM VARIABILITY AND STRESS INFLUENCE ACTIVITIES OF DAILY LIVING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S267-S267
Author(s):  
Scott E Moore ◽  
Kelly Wierenga ◽  
Heather K Hardin
Keyword(s):  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Psychological Symptoms ◽  
Psychological Symptom ◽  
Healthcare Providers ◽  
Poor Health ◽  
Symptom Variability

Abstract Stress and symptomatology have been shown to have strong relationships to health outcomes in older adults. More specifically, perceived social stressors (PSS), whether related to disease, disability or demographics, is a contributor to health. Recently it was reported that intra-individual symptom variability (ISV) may predict poor health outcomes better than symptom severity in some chronic illnesses. Individual and combined influences of ISV and PSS on health behaviors are not fully described. Using a subset (n = 518, 46.5% men; mean age = 48.7) of MIDUS Refresher participants’ 8 day daily diary data, we sought to determine the influences of physical and psychological ISV and PSS on independent and basic activities of daily living (iADLs, bADLs). The ISVs represent an average of day-to-day variation across each of the 22 physical and 27 psychological symptoms for each participant. Psychological ISV, physical ISV, PSS, and total number of chronic conditions were entered into two structural equation models as predictors for each ADL outcome (p<.01). The models depicted both direct and indirect influences of psychological ISV on ADLs (iADLs: B=-.43, P < .001; B = .51, P < .001 [through PSS]; bADLs: B=-.45, P < .001; B = .51, P < .001 [through PSS]). However, the influence of physical ISV on ADLs was indirect (B = .22, P = .001 [through PSS]). Individual-level influences of ISV and PSS on ADLs may better aide healthcare providers’ identifying and intervening to disrupt poor health outcomes for those at risk.

scholarly journals The BETA® nursing measure: Calibrating construct validity with Rasch analyses*

2015 ◽  
Vol 20 (1) ◽  
Author(s):  
Hendrik J. Loubser ◽  
Daleen Casteleijn ◽  
Judith C. Bruce
Keyword(s):  
Construct Validity ◽  
Activities Of Daily Living ◽  
Nursing Care ◽  
Rasch Model ◽  
Daily Living ◽  
Successful Outcome ◽  
Direct Result ◽  
Specific Reference ◽  
Rasch Analyses ◽  
The Rasch Model

Background: The BETA nursing measure has been introduced as a tool to routinely measure and monitor the outcomes of patients' activities of daily living in a restorative nursing care context.Objectives: To investigate the BETA's construct validity using the Rasch model with specific reference to the BETA's potential to be used as an interval scale providing metric or interval data.Method: A quantitative analytical design was followed using Rasch analyses whereby BETA raw data was collected from patients (n = 4235) receiving nursing care in 28 South African sub-acute and non-acute nursing facilities. The data was prepared for Rasch analyses and imported into WINSTEP® Software version 3.70.1.1 (2010). Final results were shown by means of figures and graphs.Results: A successful outcome was achieved by dividing the BETA into four subscales. In this process one of the original BETA items was omitted and seven other items required collapsing of their categories before the four subscales achieved a satisfactory fit to the Rasch model.Conclusion: The four BETA subscales achieved “very well” to “excellent” levels of fit to the Rasch model. This finding thus creates an opportunity to convert the BETA's Likert qualities into an interval measure to calculate change in patients' activities of daily living metric allyas a direct result of effective restorative nursing.

Validation of the NOSGER (Nurses' Observation Scale for Geriatric Patients): Reliability and Validity of a Caregiver Rating Instrument

1996 ◽  
Vol 8 (4) ◽  
pp. 525-547 ◽  
Author(s):  
Margrit Wahle ◽  
Sybille Häller ◽  
René Spiegel
Keyword(s):  
Social Behavior ◽  
Elderly Patients ◽  
Construct Validity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Patients ◽  
Observation Scale ◽  
Depressed Group ◽  
Six Dimensions ◽  
Caregiver Rating

The Nurses' Observation Scale for Geriatric Patients (NOSGER) is a rating scale for use in geriatric patients that can be applied by nurses or other caregivers. It deals with the daily behavior of elderly patients and measures impairment in six areas (dimensions): memory; instrumental activities of daily living (IADL); (basic) activities of daily living (ADL); mood; social behavior; and disturbing behavior. Objectivity, stability, construct validity, and acceptance of the scale have been established in previous studies using an earlier version of the NOSGER. The present validation study considered 50 healthy old subjects, 25 patients with mild dementia, 25 patients with advanced (mostly moderate according to DSM-III-R criteria) dementia, and 25 elderly patients with depression. The NOSGER was completed by relatives in the case of subjects living in their own homes and by nurses or other caregivers for institutionalized subjects. In addition to the NOSGER, selected tests of concentration, memory, and performance were applied as outside criteria.Interrater reliability (objectivity) was estimated by variance component analysis. Values between rtt = .68 and rtt = .89 (all p < .001) were found for the six NOSGER dimensions, the values being higher for the cognitive dimensions (memory, IADL, ADL) than for the noncognitive ones (mood, social behavior, disturbing behavior). Retest realibility (stability), which was calculated via rank order correlations, was somewhat higher for the cognitive NOSGER dimensions (memory rs = .91,IADLrs = .92, ADLrs = .88; p < .001) than for the noncognitive ones (mood rs = .85, social behavior rs = .87, disturbing behavior rs = .84; p < .001). All these values satisfy the level of rtt ≥ .80 required in accordance with psychometric standards. The concurrent validity of the NOSGER dimensions was assessed using correlations with external criteria with which similarity of content was expected. The NOSGER dimensions memory, IADL, ADL, and social behavior were found to correlate closely with external criteria of similar content, whereas no satisfactory concurrent validities were found for the dimensions mood or disturbing behavior. The NOSGER dimensions were also correlated with a number of unrelated external criteria so as to reveal any discordances. For the dimensions memory, IADL, ADL, and social behavior, no clear-cut discriminant validities were found. This suggests that these four dimensions may function as parameters not just of different areas of behavior, but also of a general factor that might be described as “cognitive intactness.” As a further aspect of construct validity, significant differences (all p < .001) between the four groups of subjects were found in five of the six NOSGER dimensions (memory, IADL, ADL, mood, social behavior): The healthy subjects differed significantly from all three patient groups in five of the six dimensions; the moderately demented group differed from the depressed group in four of the six dimensions and from the mildly demented group in two of the six dimensions; and the mildly demented group differed significantly from the depressed group in terms of mood (significance levels are after application of the Bonferroni correction). Significant group differences (p generally < .001) were also found for most of the objective performance tests used (data not presented).

scholarly journals Concurrent and Construct Validity of Scores on the Timed Movement Battery

2001 ◽  
Vol 81 (2) ◽  
pp. 789-798 ◽  
Author(s):  
Gwenda L Creel ◽  
Kathye E Light ◽  
Mary T Thigpen
Keyword(s):  
Construct Validity ◽  
Activities Of Daily Living ◽  
Barthel Index ◽  
Daily Living ◽  
Assessment Tool ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Movement Speed ◽  
Elderly Individuals ◽  
Balance Scale

Abstract Background and Purpose. The Timed Movement Battery (TMB) is a new assessment tool designed to measure mobility in elderly individuals. “Mobility” was defined as a person's ability to maneuver his or her body independently in order to accomplish everyday tasks. The purpose of this study was to assess the concurrent and construct validity of scores obtained with the TMB as a measure of mobility in a group of elderly individuals who reported moderate or no difficulty in performing either basic or instrumental activities of daily living (BADL or IADL). Subjects. Thirty community-dwelling elderly people, with a mean age of 77.5 years (SD=7.0, range=65–92), participated in this study. Methods. Subjects responded to 2 questionnaires regarding their activities of daily living (ADL) (ie, Barthel Index and an 18-item ADL/IADL scale) and completed 3 assessments of mobility (ie, Berg Balance Scale, Timed “Up & Go” Test, and the TMB). Subjects were asked to perform the items on the TMB at a “self-selected” speed (their normal speed) and at a “maximum-movement” speed (as quickly as they could safely perform the items). Subjects' scores on the TMB were cross-correlated with data for 4 criterion tests (ie, Berg Balance Scale, Timed “Up & Go” Test, Barthel Index, and the 18-item ADL/IADL scale) using Spearman rank correlations and Pearson product moment correlations. Results. Composite scores of the TMB performed at self-selected speeds correlated highly with data for the criterion tests and differentiated between those subjects reporting difficulty with ADL and those reporting no difficulty. Conclusion and Discussion. These results support the validity of scores obtained with the TMB as a measure of mobility in this sample of elderly individuals with moderate or no reported difficulty with ADL.

Longitudinal Observations of Low Back Pain Recovery

1998 ◽  
Vol 42 (14) ◽  
pp. 1013-1017
Author(s):  
Sue A. Ferguson
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Activities Of Daily Living ◽  
Outcome Measures ◽  
Discriminant Function ◽  
Daily Living ◽  
Functional Performance ◽  
Function Analysis ◽  
Low Back ◽  
Personal Factors

Most low back pain recovery studies evaluate one outcome measure at one point in time. Return to work, symptoms, activities of daily living and functional performance have been commonly used outcome measures. The goal of this project was to evaluate all four previously used outcome measures at several points in time. The second goal of the project was to predict outcome as a function of time and recovery measure. The outcome measures of working status, symptoms, and activities of daily living were measured using questionnaires. Functional performance outcome was evaluated using the lumbar motion monitor. These outcome measures were evaluated every two weeks for three months. Psychological factors, psychosocial factors, physical job demands and personal factors that may influence recovery were also evaluated. Discriminant function analysis was used to predict outcome at a specific visit given the confounding factors and any previous conditions. The cross-validation error rate for the discriminant function results ranged from 0–15%. The results showed discrepancies among the four outcome measures in there indication of recovery. This is the first study to compare multiple outcome measures at several point in time after an LBP episode.

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