Meaningful Change Estimates for the Late-Life Function and Disability Instrument in Older Adults
Meaningful Change Estimates for the Late-Life Function and Disability Instrument in Older Adults
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DOI：
10.1093/gerona/gly230
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发表时间：
2019-04-01
影响因子：
5.1
通讯作者：
Bean, Jonathan F.
中科院分区：
文献类型：
--
作者：
Beauchamp, Marla K.;Ward, Rachel E.;Bean, Jonathan F.
背景资料：晚期生活功能和残疾工具（LLFDI）是一种经过充分验证且经常使用的老年人患者报告结局。本研究的目的是估计的最小临床重要差异（MCID）的LLFDI功能组件（LLFDI-FC）和它的分量表之间的社区居住的老年人与mobilitylimits.Methods：我们进行了二次分析的波士顿反射损伤研究的老年人，纵向队列研究的老年人与流动性限制居住在社区。使用基于锚点和基于分布的方法估计1年随访期间每个LLFDI-FC量表的MCID，包括患者报告的功能量表变化总体评分的平均变化评分、测量标准误（SEM）和90%置信度下的最小可检测变化（MDC 90）。来自320名老年人的数据用于分析（平均年龄76岁，69%为女性，平均四种慢性疾病）。基于总体变化评级和SEM，LLFDI-FC总体功能量表和基础下肢、晚期下肢和上肢子量表的“微小变化”的有意义变化估计值分别为2、3、4和4分。基于总体变化评级和90%置信度下最小可检测变化，总体功能量表以及基本下肢、高级下肢和上肢子量表的“实质性变化”估计值分别为5、6、9和10分。结论：本研究提供了LLFDI-FC的首次MCID估计值，LLFDI-FC是一种广泛使用的患者报告的功能指标。这些值可以用来解释功能状态在类似的社区居住的老年人人群的纵向调查的结果。
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.