Validation of New Measures of Disability and Functioning in the National Health and Aging Trends Study
Validation of New Measures of Disability and Functioning in the National Health and Aging Trends Study
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DOI：
10.1093/gerona/glr087
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发表时间：
2011-09-01
影响因子：
5.1
通讯作者：
Wolf, Douglas A.
中科院分区：
文献类型：
--
作者：
Freedman, Vicki A.;Kasper, Judith D.;Wolf, Douglas A.
测量差距继续阻碍对晚年残疾趋势和动态的更充分了解。本文报告了新的国家健康和老龄化趋势研究中将使用的残疾方案中自我报告的部分的验证结果。该方案旨在通过关注残疾的环境方面、获取更广泛的执行任务的能力并包括参与限制项目来纠正现有措施。我们进行了一项面对面的验证研究，以确定国家健康和老龄化趋势研究自我报告残疾方案(n=326)的可靠性、有效性和初始测量特性。一个随机的子集(n=111)在2-4周内重新实施该方案。采访和重访包括新的自我报告的体能、活动限制和参与限制的测量，以及既定的表现和认知测试。我们计算了所有自我报告项目和总结测量的访谈之间的符合率和kappa。我们还通过与人口统计特征、脆弱性、记忆力和基于绩效的流动性的相关性来评估摘要测量的结构效度，并确认活动限制和参与限制是否是不同的领域。新条目和派生的摘要测量在短时间内表现出稳健性，保留/推荐条目的Kappas在0.60-0.80范围内。正如预期的那样，汇总测量与年龄、性别、居住状况和已建立的基于绩效的结构相关。代表活动限制和参与限制的两个因素得到确认。国家健康和老龄化趋势研究方案保留了检查更传统的功能衡量标准的能力，同时提供了有关活动如何进行的新见解，并保留了关键的概念区别。
Measurement gaps continue to hamper fuller understanding of late-life disability trends and dynamics. This article reports findings that validate the self-reported components of the disability protocol to be used in the new National Health and Aging Trends Study. The protocol was designed to redress existing measures by attending to environmental aspects of disability, capturing a broader range of capacity to perform tasks and including participation restriction items.We undertook an in-person validation study to determine the reliability, validity, and initial measurement properties of the National Health and Aging Trends Study self-reported disability protocol (n = 326). A random subset (n = 111) was readministered the protocol within 2-4 weeks. The interview and reinterview included new self-reported measures of physical capacity, activity limitations, and participation restrictions, as well as established performance and cognitive tests. We calculated percent agreement and kappa between interviews for all self-reported items and summary measures. We also assessed the construct validity of summary measures through correlations with demographic characteristics, frailty, memory, and performance-based mobility and confirmed whether activity limitations and participation restrictions were distinct domains.New items and derived summary measures demonstrate robustness over a short time period, with kappas for retained/recommended items in the .60-.80 range. The summary measures correlate as expected with age, sex, residential status, and established performance-based constructs. Two factors, representing activity limitations and participation restrictions, were confirmed.The National Health and Aging Trends Study protocol preserves the ability to examine more traditional measures of functioning while offering new insights into how activities are performed and preserving key conceptual distinctions.