Self-reported activities of daily living and performance-based functional ability: a study of congruence among the oldest old

Abstract

Although researchers and clinicians tend to use subjective evaluations of functioning and objective assessments interchangeably, there may be important differences between how people view their own abilities and objective indicators. This study aims to examine the relation between self-reported evaluations of function and health and performance-based (PB) measures of functional ability and objective health indicators in a sample of the oldest old. The study is based on data from a sample of 349 individuals aged 80 and older from the OCTO-Twin Study. One member of each twin pair was randomly selected for this study. The result demonstrates that subjective evaluations of functional ability are significantly associated with objective measures of health and PB measures of function although considerable variance remained unexplained. The association of PB measures to the self-report evaluations differed by measure. PB measures had stronger associations with self-reported functioning than objective health indicators such as diseases and medications. PB balance was related to self-reported function in instrumental activities in daily life (IADL) and self-reported mobility, whereas PB upper body strength and flexibility was associated with all three self-reports of function but not to perceived health. The strength of these associations did not differ from one another suggesting that PB balance and upper body strength and flexibility have comparable effects on self-reports of daily life function. From a practical perspective, our findings confirm that self-reported ADL reflects objective measures of functioning, but probably also has subjective components that need further exploration. The result also indicates a need for multiple measures in evaluating functional ability in the oldest old.

Role of cognitive resources on everyday functioning among oldest-old physically frail

“…As these questionnaires can generate biases and inaccuracies in the informant's perceptions, they are increasingly being complemented with objective performance measures of physical and cognitive tasks important for everyday functioning, such as the Timed Instrumental Activities of Daily Living test (TIADL [8]; for a review of such ADL measures, see [9]). To be noted, while with cognitively impaired older adults, a discrepancy has been observed between self-reported and objective measure of everyday functioning [10], in cognitively healthy old people, self-reported ADL measures still remain strongly related to objective measures of everyday functioning [11,12].…”

A roadmap for implementation of patient‐centered digital outcome measures in Parkinson's disease obtained using mobile health technologies

“…Patient‐centered measurement of the presence and severity of motor and nonmotor symptoms should focus on how they impair activities of daily living (ADLs) . Instrumental ADLs can include symptoms (“impairments”) and activities (“disabilities”), the latter being typically more reliable for self‐reporting measures . Domains deemed patient‐relevant cannot be identified by clinicians or researchers alone.…”

“…18 Instrumental ADLs can include symptoms ("impairments") and activities ("disabilities"), the latter being typically more reliable for self-reporting measures. 19 Domains deemed patient-relevant cannot be identified by clinicians or researchers alone. Nonetheless, selected nonmotor endpoints, such as sleep and heart rhythm monitors-both included in most common smartwatches-can be made available for shared decision-making because of their clear…”

On the different scenarios of disagreement between self- and informant-reports on an aged adults ability to perform activities of daily living

“…Many studies have investigated respondent-informant disagreement on items requiring judgments on ADLs [1,[6][7][8][9]. Few have asked: what are the scenarios from which disagreements can arise?…”

“…ADL measures from observations by trained clinicians may be the preferred method; however, self reports are more widely used in survey studies because of their low-cost and availability [6]. Because of things like weakened physical conditions, emotional indisposition, or impaired mental states, aged adults are not always able to self report on their ability to perform ADLs-which is why informant reports are widely use.…”