Validity of questions about activities of daily living to screen for dependency in older adults

Validity of questions about activities of daily living to screen for dependency in older adults

Author Reboucas, Monica Autor UNIFESP Google Scholar
Coelho-Filho, Joao Macedo Google Scholar
Veras, Renato Peixoto Google Scholar
Lima-Costa, Maria Fernanda Google Scholar
Ramos, Luiz Roberto Autor UNIFESP Google Scholar
Abstract OBJECTIVE: To determine the criterion validity of the activities of daily living present in functionality questionnaires in older adults for population surveys and to identify which activities are valid to quantify the real daily need for help of this population. METHODS: This is a population sample of older adults stratified by levels of functionality, according to self-perception of dependency in the activities of daily living. Self-perception was compared with the gold standard - direct observation of these activities in the household of older adults by a trained professional, blinded to the answers in the questionnaire. At the visit, it was decided if the older adult needed help to perform any of the activities of daily living for the research. The sensitivity of each activity of daily living was greater when the self-assessment that there was no need for help coincided with the assessment of the professional. Specificity indicates coincidence regarding the need for help in the activities of daily living - coefficients of sensitivity and specificity above 70% were considered as indicative of good validity. RESULTS: Self-assessments showed better sensitivity than specificity - older adults and observers agreed more on daily independency than on dependency. All activities showed sensitivity above 70%. Some activities had low (go shopping: 55%) or very low specificity (brush the hair: 33%). The best specificities were to take a shower and dress up (95.8% for both), among the personal ones, and to use transportation and perform banking transactions (78% for both), among the instrumental ones. CONCLUSIONS: Activities of daily living can be valid indicators of functional dependence. The best coefficients of validity were generally obtained for personal activities. Some activities with good sensitivities and specificities - walk 100 meters, take a shower, and lie down in and get out of the bed - can be used to classify older adults into low, average, and high need for help depending on the affected activities and, therefore, can help in the planning of health services aimed at them.
Keywords Aged
Activities of Daily Living
Independent Living
Diagnostic Self Evaluation
Surveys and Questionnaires, utilization
Validation Studies
xmlui.dri2xhtml.METS-1.0.item-coverage Sao Paulo
Language English
Sponsor National Council for Scientific and Technological Development (CNPq)
Grant number CNPq: 555070/2006-9
Date 2017
Published in Revista De Saude Publica. Sao Paulo, v. 51, p. -, 2017.
ISSN 0034-8910 (Sherpa/Romeo, impact factor)
Publisher Revista De Saude Publica
Extent -
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000410607400012

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