Article

OBJECTIVE: To compare activities of daily living (ADL) staging based on 2-level
responses to ADL difficulty questions (simple ADL stages) with ADL staging based
on 4-level ADL question responses (complex ADL stages). DESIGN: Analysis of the
Second Longitudinal Study of Aging, a prospective cohort study, using descriptive
statistics and logistic regression. SETTING: Participants' homes. PARTICIPANTS:
Community-dwelling persons (N=9447) aged >/=70 years in 1994. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: (1) Agreement and face validity: baseline
simple ADL stage; (2) construct validity: baseline health, difficulty, and need
characteristics; (3) prognostic comparison (determined at the Wave 2 interview):
primary-nursing home use and/or death; secondary-death. RESULTS: The systems
showed good agreement (kappa=.75). The simple ADL stages stratified people into
distinct groups and reflected the expected stepwise increases from stage 0 to
stage IV in health and need characteristics, such as the prevalence of
home-related challenges (2.9%-84.5%) and perceived need for home modifications
(2.1%-33.6%). In comparing the prognostic ability using the primary outcome, the
complex system model demonstrated slightly increased discrimination between
milder stages and a slightly higher C statistic (.666 vs .664). CONCLUSIONS:
Although complex staging appears slightly better at classifying people into
distinct prognostic strata with respect to nursing home use and/or death at Wave
2, simple ADL stages demonstrate strong, clinically relevant associations with
health and need characteristics.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS