Detection of activity limitations in older adults with MCI or Alzheimer's disease through evaluation of perceived difficulty in use of everyday technology: a replication study

Objectives and methods: Earlier research indicates that the ability to use everyday technology (ET) may be sensitive to subtle functional change. People with mild cognitive impairment (MCI) have been identified as significantly more disabled in ET use compared to controls, albeit less disabled than people with dementia. The aim of this study was to investigate the replicability of these findings using an improved version of the Everyday Technology Use Questionnaire (ETUQ) to compare perceptions of relevance and difficulty in ET use in participants with MCI or Alzheimer's disease (AD) and controls. Additional aims were to explore the validity of ETUQ, and the relationships between perceived difficulty in ET use and cognitive status, mood state, and involvement in everyday life activities. In total, 118 participants were included, 37 with AD, 37 with MCI, and 44 controls.

Results: Analyses confirmed that the rating scale of the ETUQ functioned well. The three groups overlapped but differed significantly in their perceptions of ETs relevance (p?p?r?=?0.563).

Conclusion: Taken together, the findings underscore the plausibility of disability already in people with MCI, as the use of ET strongly correlates to involvement in activities. It is therefore important that professionals who meet older adults with cognitive impairment take this aspect of function into account in assessments and targeted interventions.     

Making use of research: Clinical views on an evaluation of everyday technology use

Objective: The study aim was to investigate how and when an evaluation of perceived difficulty in use of everyday technology (Everyday Technology Use Questionnaire, ETUQ) could be used in clinical occupational therapy. Method: Eight focus-group interviews were undertaken with a total of 42 participants (occupational therapists), and data were analysed with a constant comparative approach. Results: The findings are presented in four main categories, including (i) appropriate purposes and contexts for using ETUQ, (ii) standardization versus individual flexibility, (iii) approaching everyday technology use and occupation as one whole, and (iv) synthesizing and documentation. Conclusions: In conclusion, the participants considered ability to use technology to be an important topic for occupational therapy, particularly in investigations of clients with subtle disabilities and in connection with discharge from hospital – but not in inpatient care. They had different views on how to integrate ETUQ with evaluations of occupational performance, and new ideas on how information about clients’ ability to use technology could be utilized in interventions. They held standardized evaluations in high regard, but a paradox appeared in that many of them would use ETUQ in a non-standardized way, while simultaneously asking for a standardized output to be used in clients’ medical files and to guide interventions.     

2011年济宁市城区部分老年人日常生活活动能力评价

[目的]了解济宁市老年人基本日常生活活动能力和工具性日常生活活动能力,为社区及乡镇卫生服务机构有效开展老年卫生服务和健康维护提供参考。[方法]2011年3～4月,采用多阶段随机抽样方法,在济宁市城区抽取≥65岁常住户口的老年504人应用Katz日常生活活动量表(Katz-ADL)和工具性日常生活活动量表(Lawton-IADL)进行调查。[结果]测评人504人,Katz-ADL得分为5.66±0.91分。6项功能均保持的占80.95%,6项功能均丧失的占0.79%。6项功能均保持者所占比例,男性为86.67%,女性为74.36%(P<0.01)。测试的504人中,Lawton-IADL得分:男性为3.72±1.59分,女性为5.06±2.83分。其中,男女相同的5项功能均保持者所占比例为33.53%,男性为44.08%,女性为21.37%(P<0.01);5项功能均丧失者所占比例为11.31%,男性为7.78%,女性为15.38%(P<0.01)。[结论]济宁市城区老年人日常生活活动能力和工具使用生活能力较高,多项生活活动能力保持率男性高于女性。     

Overestimated functional dependency in older patients: Can we blame gender difference,unneeded assistance or assessment tools?

IntroductionThe population is aging in Egypt and hence functional limitation is increasing. Thus finding the best measures for its detection is mandated.ObjectivesThe aim of this study was to assess whether Katz ADL (activities of daily living) and Lawton IADL (instrumental activities of daily living) were suitable measures to represent the functional abilities of older Egyptians of both genders during hospital admission and to determine the dimensionality of both tools.MethodsFunctional status was assessed during hospital admission as a part of the comprehensive geriatric assessment for 786 older patients (aged 60 years and older). 150 of them were randomly interviewed to collect data regarding the difficulty during each task of Katz ADL and Lawton IADL performance, unnecessary and unmet needed assistance, barriers to get needed assistance and the type of care providers.ResultsThe prevalence of ADL and IADL dependency was 61.80 % and 85.87 %, respectively. Functional limitation in both scales was found to be significantly associated with increasing age, marital status other than married, cognitive impairment. Both scales showed a bi-dimensional factor structure, removing continence from Katz ADL resulted in a uni-dimensional scale. Females were more dependent than males in all tasks except household tasks of IADL.ConclusionsKatz ADL and Lawton IADL did not capture the actual dependency level among older Egyptians. The household tasks in Lawton IADL and continence in Katz ADL mislabeled dependency in the studied sample.     

Patient Satisfaction and Perceived Quality of Care Among Younger Medicare Beneficiaries According to Activity Limitation Stages

Objective

To examine the association between activity limitation stages and patient satisfaction and perceived quality of medical care among younger Medicare beneficiaries.

Validity and reliability of a Malay version of the Lawton instrumental activities of daily living scale among the Malay speaking elderly in Malaysia

Background/aim

The Lawton Instrumental Activities of Daily Living Scale is a tool often used to assess independence among elderly at home. Its suitability to be used with the elderly population in Malaysia has not been validated. This current study aimed to assess the validity and reliability of the Lawton Instrumental Activities of Daily Living Scale – Malay Version to Malay speaking elderly in Malaysia.

Methods

This study was divided into three phases: (1) translation and linguistic validity involving both forward and backward translations; (2) establishment of face validity and content validity; and (3) establishment of reliability involving inter‐rater, test‐retest and internal consistency analyses. Data used for these analyses were obtained by interviewing 65 elderly respondents.

Results

Percentages of Content Validity Index for 4 criteria were from 88.89 to 100.0. The Cronbach α coefficient for internal consistency was 0.838. Intra‐class Correlation Coefficient of inter‐rater reliability and test‐retest reliability was 0.957 and 0.950 respectively.

Conclusions

The result shows that the Lawton Instrumental Activities of Daily Living Scale – Malay Version has excellent reliability and validity for use with the Malay speaking elderly people in Malaysia. This scale could be used by professionals to assess functional ability of elderly who live independently in community.