Abstract
Objectives: Although assessment of daily functioning is crucial in diagnosing cognitive disorders, commonly used
evaluations of activities of daily living (ADL) such as the Katz (basic (b-)ADL) and Lawton scale (instrumental (i-)ADL)
have clinical and scientific shortcomings (Yang et al., 2014). They have poor or uninvestigated psychometric properties
and a lack of uniformity in items and scoring systems (e.g. Sikkes et al., 2009). This study aimed to translate the Katz and
Lawton scale to the comprehensive terminology and scoring system of the International Classification of Functioning,
Disability and Health (ICF), the current reference in health care (WHO, 2001).
Methods: A qualitative analysis based on in-depth interviews was used to gain insight in individual experiences and
slopes of decline in performing b- and i- ADL. Geriatric patients (n=50) with a broad range of cognitive and functional
decline were included. Narratives were analysed by "constant comparison" and results were linked to the terminology and
scoring system of the ICF. To enhance reliability, peer debriefing by a multidisciplinary team of experts was used.
Results: Each item of the Katz and Lawton scale could be linked to an ICF-category. Further analysis of the reported
diminished performance skills resulted in a clear description of the ICF-scoring system ranging from autonomy (score 0)
towards complete dependency (score 4). Reported reasons for limitations could be related to body functions and
structures or to personal and environmental elements, also classified in the ICF. This allows assigning an underlying
cause of performance limitations.
Conclusion: This study resulted in an ameliorated ICF-based evaluation of b- and i-ADL, including a uniform language,
scoring guideline and flow-chart. This improved scoring system discriminates between physical and cognitive causes of
limited b- and i-ADL performance, which is important in the diagnosis of cognitive disorders. On going research explores
the psychometric properties of this evaluation in order to determine its value in diagnosing cognitive disorders.
evaluations of activities of daily living (ADL) such as the Katz (basic (b-)ADL) and Lawton scale (instrumental (i-)ADL)
have clinical and scientific shortcomings (Yang et al., 2014). They have poor or uninvestigated psychometric properties
and a lack of uniformity in items and scoring systems (e.g. Sikkes et al., 2009). This study aimed to translate the Katz and
Lawton scale to the comprehensive terminology and scoring system of the International Classification of Functioning,
Disability and Health (ICF), the current reference in health care (WHO, 2001).
Methods: A qualitative analysis based on in-depth interviews was used to gain insight in individual experiences and
slopes of decline in performing b- and i- ADL. Geriatric patients (n=50) with a broad range of cognitive and functional
decline were included. Narratives were analysed by "constant comparison" and results were linked to the terminology and
scoring system of the ICF. To enhance reliability, peer debriefing by a multidisciplinary team of experts was used.
Results: Each item of the Katz and Lawton scale could be linked to an ICF-category. Further analysis of the reported
diminished performance skills resulted in a clear description of the ICF-scoring system ranging from autonomy (score 0)
towards complete dependency (score 4). Reported reasons for limitations could be related to body functions and
structures or to personal and environmental elements, also classified in the ICF. This allows assigning an underlying
cause of performance limitations.
Conclusion: This study resulted in an ameliorated ICF-based evaluation of b- and i-ADL, including a uniform language,
scoring guideline and flow-chart. This improved scoring system discriminates between physical and cognitive causes of
limited b- and i-ADL performance, which is important in the diagnosis of cognitive disorders. On going research explores
the psychometric properties of this evaluation in order to determine its value in diagnosing cognitive disorders.
| Original language | English |
|---|---|
| Title of host publication | IPA European Regional Meeting |
| Place of Publication | Brussels, Belgium |
| Publisher | International Psychogeriatrics Association |
| Publication status | Published - 5 Dec 2014 |
| Event | International Psychogeriatric Association European Regional Meeting - Brussels, Belgium Duration: 3 Dec 2014 → 5 Dec 2014 |
Conference
| Conference | International Psychogeriatric Association European Regional Meeting |
|---|---|
| Country/Territory | Belgium |
| City | Brussels |
| Period | 3/12/14 → 5/12/14 |
Keywords
- Assessment of daily functioning,
- International Classification of Functioning
- Mild Cognitive Impairment
- Alzheimer's disease