Screening for pre-clinical disability in different residential settings

Abstract

BackgroundPreventing disability and offering effective interventions to older people during early decline in function is most likely to be effective if those most at risk of progressive disablement are able to be identified. Similarly the ability to easily identify a group with similar functional profile from disparate sectors of the community is of significant benefit to researchers. This study aimed to (1) describe the use of a pre-clinical disability screening tool to select a functionally comparable group of older men and women with early functional limitation from different settings, and (2) explore factors associated with function and disability.MethodsSelf-reported function and disability measured with the Late-Life Function and Disability Instrument along with a range of physical performance measurements were compared across residential settings and gender in a sample of 471 trial participants identified as pre-clinically disabled after being screened with the Fried pre-clinical disability tool. Factors that might lie on the pathway to progressive disablement were identified using multiple linear regression analysis.ResultsWe found that a sample population, screened for pre-clinical disability, had a functional status and disability profile reflecting early functional limitation, regardless of residential setting or gender. Statistical models identified a range of factors associated with function and disability which explained a greater degree of the variation in function, than disability.ConclusionsWe selected a group of people with a comparable function and disability profile, consistent with the pre-clinical stage of disability, from a sample of older Australian men and women from different residential settings using the Fried pre-clinical disability screening tool. The results suggest that the screening tool can be used with greater confidence for research, clinical and population health purposes. Further research is required to examine the validity of the tool. These findings offer insight into the type of impairment factors characterising early functional loss that could be addressed through disability prevention initiatives.Trial RegistrationACTRN01206000431527

Psychometric properties of the Late-Life Function and Disability Instrument: a systematic review

“…Unlike the Function component, the Disability component did not discriminate between groups based on residence status [29], urinary incontinence [37] or fall status [51]. Evidence for known-groups validity was strongest for the limitation dimension and associated instrumental role domain compared to the frequency dimension and associated domains.…”

“…In total, the LLFDI was administered to 17,301 older adults with individual study sample sizes ranging from 11 [ 28 ] to 1,441 [ 27 ]. The majority of studies were conducted in the United States, however the LLFDI has also been used in Canada [ 21 , 22 , 24 , 32 , 48 , 58 - 60 , 64 ], Israel [ 37 , 51 , 52 , 72 ], Australia [ 17 , 23 , 29 ], New Zealand [ 39 , 67 ], Iceland [ 12 , 13 ], and the United Kingdom [ 24 ]. The study designs included cross-sectional, cohort and clinical trials.…”

Measures of disability: Arthritis Impact Measurement Scales 2 (AIMS2), Arthritis Impact Measurement Scales 2‐Short Form (AIMS2‐SF), The Organization for Economic Cooperation and Development (OECD) Long‐Term Disability (LTD) Questionnaire, EQ‐5D, World Health Organization Disability Assessment Schedule II (WHODASII), Late‐Life Function and Disability Instrument (LLFDI), and Late‐Life Function and Disability Instrument‐Abbreviated Version (LLFDI‐Abbreviated)

“…The LLFDI has been used with older adults across a range of health conditions including osteoarthritis, multiple sclerosis, stroke, heart disease, cancer, urinary incontinence, rehabilitation studies, and general population studies of older adults. The measure has also been used as a screening tool, to describe the impact of various health conditions, and as an outcome in intervention studies such as physical activity and health care service interventions (116–121).…”

Psychosocial Factors Associated With Reduced Muscle Mass, Strength, and Function in Residential Care Apartment Complex Residents

“…Most studies of RCAC residents report only general functional ability, such as activities of daily living (ADL), and no benchmarks exist for functional data (Giuliani et al, 2008;Roberts et al, 2013). Although measures of ADL are valuable for identifying disability level, they are not useful for detecting modifi able muscle function impairments that lead to disability (Gibson et al, 2010;Giuliani et al, 2008). Being able to precisely measure muscle health of older adults living in RCACs could potentially provide new information to better distinguish older adults at risk for placement into LTC facilities or nursing homes from those who are more likely to successfully age in their home environment.…”