Comprehensive Activities of Daily Living (ADL) Index for the Elderly

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Abstract

In order to measure disability in the elderly with a variety of handicaps a comprehensive activities of daily living (ADL) index is described. This instrument, named the ADL-20, consists of 20 items from four major categories of daily activities: (1) 5 itmes from basic ADL for mobility (BADLm), (2) 6 items from basic ADL for self-care (BADLs), (3) 7 items from instrumental ADL (IADL), and (4) 2 items from communication ADL (CADL). Each activity is scored on a four point scale with values from 0 (total dependency) to 3 (independency). In order to study the interrater reliability of the instrument 40 subjects were examined by a physician and physiotherapist independently at the University of Tokyo Hospital on the same day. Perfect agreement rates on the assignment of the disability score ranged from 70.0% to 97.5% with 85.6% in 800 paired examinations. The kappa values for perfect agreement ranged from 0.52 to 0.88. These results may guarantee a moderate or greater degree of interrater reliability. The correlation coefficients of the Spearman test on the rating scores by the physician and physiotherapist ranged from 0.66 to 0.99 in each activity with 0.97 in total score of 20 items. This scale was employed in 110 patients at the University Hospital and 106 patients staying in the nursing home or long-stay geriatric hospital in order to study its validity. The average age of those 216 patients, 77 males and 139 females, was 76.2 years old. The Cronbach a value concerning the consistency of each item as ADL assessment scale was 0.97. The Spearman correlation coefficient between the total ADL-20 score and the grade of individual home care needs was -0.88. Among the 4 subgroups of ADL, IADL showed the greatest correlation coefficient value. In this validity study the Barthel index (BT) and the Katz index (KI) as well as the ADL-20 were employed in 110 university hospital patients on the same day. The correlation coefficient between BI and the ADL-20 was 0.81 and that between KI and the ADL-20 was 0.80. The correlation coefficient between the mental state assessment and the ADL-20 was 0.75. Among the subgroups of ADL IADL showed the greatest coefficient value in the correlation study between ADL and mental status. This comprehensive ADL index is sufficiently reliable and valid for the assessment of the elderly with a variety of physical or mental disabilities, owing to the IADL category items included. © 1992, The Japan Geriatrics Society. All rights reserved.

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APA

Eto, F., Tanaka, M., Chishima, M., Igarashi, M., Mizoguchi, T., Wada, H., & Iijima, S. (1992). Comprehensive Activities of Daily Living (ADL) Index for the Elderly. Japanese Journal of Geriatrics, 29(11), 841–848. https://doi.org/10.3143/geriatrics.29.841

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