Measuring the Activities of Daily Living: Comparisons Across National Surveys

Abstract

The "activities of daily living," or ADLs, are the basic tasks of everyday life, such as eating, bathing, dressing, toileting, and transferring. Reported estimates of the size of the elderly population with ADL disabilities differ substantially across national surveys. Differences in which ADL items are being measured and in what constitutes a disability account for much of the variation. Other likely explanations are differences in sample design, sample size, survey methodology, and age structure of the population to which the sample refers. When essentially equivalent ADL measures are compared, estimates for the community-based population vary by up to 3.1 percentage points; and for the institutionalized population, with the exception of toileting, by no more than 3.2 percentage points. As small as these differences are in absolute terms, they can be large in percent differences across surveys. For example, the National Medical Expenditure Survey estimates that there are 60 percent more elderly people with ADL problems than does the Supplement on Aging.

Education, Elderly Health, and Differential Population Aging in South Korea: A Demographic Approach

“…We classify respondents as -functionally limited in IADLs‖ if they report a limitation in any of these ten items. These two measures of functional limitations complement self-reported health in that they measure different aspects of independent living among the elderly (Wiener et al 1990). …”

Chronic disability trends in elderly United States populations: 1982–1994

“…Measurement is less difficult for severe disability, where physical manifestations are readily observed and evaluated. Despite these methodological issues, measurements of disability are surprisingly robust, with national estimates of the prevalence of chronic, severe disability in the elderly shown to agree across several national surveys, even with differences in questionnaire wording, in a large federal interagency study (32). If assessed with the same instrument over time, and using similarly structured and coordinated samples, the likelihood of bias in estimates of prevalence change would be further reduced.…”

Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study.

“…i e -: but initial cognitive scores were not signifihe -,-;:`c ant predictors of future functional depenee dence in other investigations.22 '23 In the present study, a population-based sample of adults aged 75 years and older liviring in a defined area of Stockholm was examined at baseline and after a 3-year follow-up. The purposes of this report are (1) to describe the prevalence of functional dependence in the very old and its relationship to chronic medical conditions, (2) to detect risk factors for developing long-term (3-year) functional dependence and functional decline, and (3) to contrast determinants of functional dependence between demented and nondemented subjects.…”