Extending the Range of Functional Assessment in Older Adults: Development of the Late-Life Function and Disability Instrument

2002 ◽  
Vol 10 (4) ◽  
pp. 453-465 ◽  
Author(s):  
Stephen M. Haley ◽  
Larry H. Ludlow ◽  
Jill T. Kooyoomjian
Keyword(s):  
Older Adults ◽  
Physical Functioning ◽  
Late Life ◽  
Theory Model ◽  
Community Dwelling ◽  
Activity Assessment ◽  
Sf 36 ◽  
Community Dwelling Older Adults ◽  
Content Range ◽  
Life Function

As a preliminary step in developing the physical-functioning measure of the Late-Life Function and Disability Instrument (LLFDI), the authors compared its items with the physical-functioning items (PF-10) on the SF-36 Health Survey. They compared the item coverage, hierarchy, and scale-separation properties of the PF-10 items with those of the physical-functioning items of the LLFDI. Both questionnaires were administered to 50 community-dwelling older adults. A partial-credit, 1-parameter, item-response-theory model was used to scale the items. The LLFDI improved the range of ability of daily activities that was encompassed by the PF-10 items by 46%. By sequentially deleting new items with poor fit to the overall scale and items with redundant content, the authors developed a scale more capable of accurately assessing low-functioning activities. The LLFDI function component incorporates a broader content range and better person and item separation than the PF-10 items. It appears to have potential as a comprehensive functional-activity assessment for community-dwelling older adults.

scholarly journals Reliability and Validity of the Korean Late-Life Function and Disability Instrument

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1200
Author(s):  
Da Sol Park ◽  
Hae Yean Park
Keyword(s):  
Older Adults ◽  
Reliability And Validity ◽  
Late Life ◽  
Factor Loading ◽  
Community Dwelling ◽  
Cultural Validity ◽  
High Internal Consistency ◽  
Community Dwelling Older Adults ◽  
Very High ◽  
Life Function

The purpose of this study was to develop the Korean version of the Late-Life Function and Disability Instrument (K-LLFDI) and verify its reliability and validity. Fifty community-dwelling older adults aged 65 years and above with independent mobility were surveyed. The reliability and validity of the instrument were verified. The overall cultural validity of 48 items was evaluated as very high (0.95), and only one item that was not appropriate was revised. The reliability of the remaining six domains was either high or very high. Internal consistency was high (α = 0.859) in the Disability component of the instrument and very high (α = 0.914) in the Function component. The factor loading for 42 out of 48 items was above 0.04. Overall, each component was well reflected by the sub-items. The K-LLFDI is expected to be instrumental in solving the rapidly growing problems of community-dwelling older adults.

scholarly journals Mental, Physical and Social Functioning in Independently Living Senior House Residents and Community-Dwelling Older Adults

2021 ◽  
Vol 18 (23) ◽  
pp. 12299
Author(s):  
Anna-Maria Lahti ◽  
Tuija M. Mikkola ◽  
Minna Salonen ◽  
Niko Wasenius ◽  
Anneli Sarvimäki ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Social Environment ◽  
Physical Functioning ◽  
Community Dwelling ◽  
Mental Functioning ◽  
Social Contacts ◽  
Sf 36 ◽  
The Social ◽  
Community Dwelling Older Adults

Senior houses provide social interaction and support, potentially supporting older people’s physical and mental functioning. Few studies have investigated functioning of senior house residents. The aim was to compare functioning between senior house residents and community-dwelling older adults in Finland. We compared senior house residents (n = 336, 69% women, mean age 83 years) to community-dwelling older adults (n = 1139, 56% women, mean age 74 years). Physical and mental functioning were assessed using the SF 36-Item Health Survey. Loneliness and frequency of social contacts were self-reported. The analyses were adjusted for age, socioeconomic factors and diseases. Physical functioning was lower among men in senior houses compared to community-dwelling men (mean 41.1 vs. 46.4, p = 0.003). Mental functioning or the frequency of social contacts did not differ between type of residence in either sex. Loneliness was higher among women in senior houses compared to community-dwelling women (OR = 1.67, p = 0.027). This was not observed in men. Results suggest that women in senior houses had similar physical and mental functioning compared to community-dwelling women. Male senior house residents had poorer physical functioning compared to community-dwelling men. Women living in senior houses were lonelier than community-dwelling women despite the social environment.

scholarly journals Meaningful Change Estimates for the Late-Life Function and Disability Instrument in Older Adults

2018 ◽  
Vol 74 (4) ◽  
pp. 556-559 ◽  
Author(s):  
Marla K Beauchamp ◽  
Rachel E Ward ◽  
Alan M Jette ◽  
Jonathan F Bean
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Community Dwelling ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Mobility Limitations ◽  
Meaningful Change ◽  
Patient Reported ◽  
Community Dwelling Older Adults ◽  
Life Function

Abstract Background The Late-Life Function and Disability Instrument (LLFDI) is a well-validated and frequently used patient-reported outcome for older adults. The aim of this study was to estimate the minimal clinically important difference (MCID) of the LLFDI-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations. Methods We performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly, a longitudinal cohort study of older adults with mobility limitations residing in the community. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated using both anchor- and distribution-based methods, including mean change scores on a patient-reported global rating of change in function scale, the standard error of measurement (SEM), and the minimal detectable change with 90% confidence (MDC90). Results Data from 320 older adults were used in the analysis (mean age 76 years, 69% female, mean of four chronic conditions). Meaningful change estimates for “small change” based on the global rating of change and SEM were 2, 3, 4, and 4 points for the LLFDI-FC overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Estimates for “substantial change” based on the global rating of change and minimal detectable change with 90% confidence were 5, 6, 9, and 10 points for the overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Conclusion This study provides the first MCID estimates for the LLFDI-FC, a widely used patient-reported measure of function. These values can be used to interpret the outcomes of longitudinal investigations of functional status in similar populations of community-dwelling older adults.

scholarly journals The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Omar Yaxmehen Bello-Chavolla ◽  
Carlos Alberto Aguilar-Salinas ◽  
José Alberto Avila-Funes
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Community Dwelling ◽  
Related Factors ◽  
Dementia Risk ◽  
Sf 36 ◽  
Community Dwelling Older Adults

Abstract Background The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D. Methods We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles. Results Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures. Conclusion The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.

scholarly journals Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Eleftheria Giannouli ◽  
Michelle Pasquale Fillekes ◽  
Sabato Mellone ◽  
Robert Weibel ◽  
Otmar Bock ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Functioning ◽  
Real Life ◽  
Cardiovascular Fitness ◽  
Community Dwelling ◽  
Sensor Data ◽  
Maximum Temperature ◽  
Life Space ◽  
Community Dwelling Older Adults

Abstract Background Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults. Methods Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days. Results Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5–30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models. Conclusions In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.

scholarly journals Effectiveness and cost-effectiveness of personalised dietary advice aiming at increasing protein intake on physical functioning in community-dwelling older adults with lower habitual protein intake: rationale and design of the PROMISS randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040637
Author(s):  
Ilse Reinders ◽  
Hanneke A H Wijnhoven ◽  
Satu K Jyväkorpi ◽  
Merja H Suominen ◽  
Riikka Niskanen ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Functioning ◽  
Protein Intake ◽  
Intervention Group ◽  
Community Dwelling ◽  
Dietary Advice ◽  
Control Group ◽  
Randomised Controlled ◽  
Community Dwelling Older Adults ◽  
Habitual Protein Intake

IntroductionShort-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive.Methods and analysisThe PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein intake to at least 1.2 g/kg aBW/day. Intervention group 2 (n=88) receives the same advice as described for intervention group 1, and in addition advice to consume 7.5–10 g protein through protein-(en)rich(ed) foods within half an hour after performing usual physical activity. The control group (n=88) receives no intervention. All participants will be invited to attend lectures not related to health. The primary outcome is a 6-month change in physical functioning measured by change in walk time using a 400 m walk test. Secondary outcomes are: 6-month change in the Short Physical Performance Battery score, muscle strength, body composition, self-reported mobility limitations, quality of life, incidence of frailty, incidence of sarcopenia risk and incidence of malnutrition. We also investigate cost-effectiveness by change in healthcare costs.DiscussionThe PROMISS trial will provide evidence whether increasing protein intake, and additionally optimising the timing of protein intake, has a positive effect on the course of physical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day.Ethics and disseminationThe study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval: HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval: 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry).Trial registration numberClinicalTrials.gov Registry (NCT03712306).

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