The Classic Measure of Disability in Activities of Daily Living Is Biased by Age but an Expanded IADL/ADL Measure Is Not
The Classic Measure of Disability in Activities of Daily Living Is Biased by Age but an Expanded IADL/ADL Measure Is Not
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DOI：
10.1093/geronb/gbp129
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发表时间：
2010-11-01
影响因子：
6.2
通讯作者：
LaPlante, Mitchell P.
中科院分区：
文献类型：
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作者：
LaPlante, Mitchell P.
根据需要帮助，按年龄评价2项残疾指标的表现：一组使用5种经典的日常生活活动（ADL），另一组使用14种扩展活动，包括工具性日常生活活动（IADL）、步行、外出和ADL使用Guttman和项目反应理论（IRT）缩放方法，（N = 25，470）对18岁及以上个体的全国代表性家庭调查。ADL项目的Guttman可扩展性随年龄稳步增加，在75岁及以上达到高水平。这反映在一个IRT模型中的年龄相关的差异项目功能（DIF），导致年龄偏倚的ADL测量。IADL/ADL项目的Guttman可测量性也随年龄增加而增加，但低于ADL。虽然与年龄相关的DIF也发生在IADL/ADL项目中，但DIF的幅度较低，并且在不引起年龄偏差的情况下平衡。IADL/ADL量表测量帮助需求是分层的，一维的，并且不受年龄的影响。它有更大的内容效度测量需要帮助的社区，并显示出更大的敏感性，年龄比经典的ADL措施。随着所有年龄段的成年人对社区服务的需求不断增加，扩展的IADL/ADL测量比ADL更有用。
To evaluate, by age, the performance of 2 disability measures based on needing help: one using 5 classic activities of daily living (ADL) and another using an expanded set of 14 activities including instrumental activities of daily living (IADL), walking, getting outside, and ADL (IADL/ADL).Guttman and item response theory (IRT) scaling methods are used with a large (N = 25,470) nationally representative household survey of individuals aged 18 years and older.Guttman scalability of the ADL items increases steadily with age, reaching a high level at ages 75 years and older. That is reflected in an IRT model by age-related differential item functioning (DIF) resulting in age-biased measurement of ADL. Guttman scalability of the IADL/ADL items also increases with age but is lower than the ADL. Although age-related DIF also occurs with IADL/ADL items, DIF is lower in magnitude and balances out without causing age bias.An IADL/ADL scale measuring need for help is hierarchical, unidimensional, and unbiased by age. It has greater content validity for measuring need for help in the community and shows greater sensitivity by age than the classic ADL measure. As demand for community services is increasing among adults of all ages, an expanded IADL/ADL measure is more useful than ADL.