A review of instrumental ADL assessments for use with elderly people

Abstract

The concept of formal or standardized tests for assessing function came to the fore in the 1960s. Katz et al. acknowledged the hierarchical nature of activities of daily living (ADL) such as eating, continence, transferring, going to the toilet, dressing and bathing in his ’Index of ADL’ and by 1968 ‘ADL’ was an accepted Index Medicus category. The definition of instrumental activities of daily living (IADL) began in 1969 with the work of Lawton and Brody who presented two scales to assess function which recognized the different degrees of complexity required for performing functional tasks. The first scale, taking life maintenance and activities essential for self-care as the primary level, was called the Physical Self-Maintenance Scale.

Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease

“…Ward et al [35] observed that no IADL scale is right for every person and there is no consensus about which activities should be included. More updated reviews also conclude that there is no ‘gold standard' on how to assess IADL [13,31].…”

Comparative validity of seven scoring systems for the instrumental activities of daily living scale in rural elders

“…Measuring functional ability is an important task in research and clinical settings, especially for elderly patients (Katz, 1983;Myers, 1992;Ward, Jagger, & Harper, 1998). A number of measures of instrumental activities of daily living (IADL; e.g., using the telephone, managing personal finances, preparing food) have been developed for this purpose (Lindeboom, Vermeulen, Holman, & De Haan, 2003;Ward et al, 1998), and Lawton and Brody's (1969) eight-item IADL scale is among the most commonly used.…”

“…A number of measures of instrumental activities of daily living (IADL; e.g., using the telephone, managing personal finances, preparing food) have been developed for this purpose (Lindeboom, Vermeulen, Holman, & De Haan, 2003;Ward et al, 1998), and Lawton and Brody's (1969) eight-item IADL scale is among the most commonly used. Although Lawton and Brody initially scored this instrument using a hierarchical Guttman framework, sums of dichotomously (less able versus more able), trichotomously (0, 1, 2) and polytomously (e.g., 1-5 point scale of increasing disability) keyed items are common, and some researchers advocate Rasch (empirically equal-interval) scores for IADL scales.…”

“…Likely the most common procedure today is summing item ratings to derive a total IADL score (Ward et al, 1998). The summed items are often rated dichotomously (e.g., 0 ¼ less able, 1 ¼ more able; Kuchibhatla & Fillenbaum, 2003) trichotomously (e.g., 1 ¼ unable, 2 ¼ able with help, 3 ¼ able without help; Boyle et al, 2003) or on a polytomous scale (e.g., some items rated 1-3, 1-4, and 1-5; Cromwell, Eagar, & Poulos, 2003).…”

Rising Food Insecurity and Conservative Policy in the US: Impact on the Elderly

“…IADLs are not necessary for fundamental functioning, but permit an individual to live independently in a community. Since IADL function is often lost before ADL function, assessment of IADLs may identify incipient cognitive or physical decline in an otherwise capable and healthy older adult (Ward, Jagger, & Harper, 1998). A combined summary score ranges from 0 to 8 (low function to high function) on the Lawton Scale.…”