The revised direct assessment of functional status for independent older adults - PubMed (original) (raw)
The revised direct assessment of functional status for independent older adults
Graham J McDougall et al. Gerontologist. 2010 Jun.
Abstract
Purpose: The original version of the Direct Assessment of Functional Status (DAFS), a measure of instrumental activities of daily living (IADLs), was found to have a ceiling effect in older adults living independently in the community. This suggested that the tasks measured, although relevant, do not require full use of this population's abilities, and thus, the instrument may not be sensitive to the early decrements in IADLs that can signal initial cognitive impairment and may not detect improvements in IADLs over time, which is especially important in intervention research.
Design and methods: By removing items with little to no variation and adding more difficult subscales that emphasized medication management skills, we designed the DAFS-Extended (Direct Assessment of Functional Status-Revised [DAFS-R]) to be more challenging for elders living independently.
Results: Analysis with a sample of 45 older adults suggested that scores on the DAFS-R appear to be more normally distributed than on the original version. The DAFS was able to differentiate individuals with varying standard profile scores on the Rivermead Behavioural Memory Test memory performance instrument (normal, poor, and impaired). In addition, the reliability and validity of the DAFS-R were supported in this sample.
Implications: Given the large number of older adults who regularly take multiple prescription medications, deficits in medication management skills can have serious consequences. A performance measure that emphasizes these higher level daily living skills can help providers screen for initial signs of functional decline.
Figures
Figure 1.
Frequency histogram of scores on the 85-item Direct Assessment of Functional Status (DAFS) at Time 1 of the SeniorWISE study for the 45 individuals in the present study.
Figure 2.
Frequency histogram of scores on the 55-item Direct Assessment of Functional Status-Revised (DAFS-R).
Similar articles
- Pre-Morbid IQ Moderates the Relationship between Cognitive Performance and Performance-Based Functional Status in Older Adults.
Robinson TL, Gogniat MA, Jean KR, Miller LS. Robinson TL, et al. Clin Gerontol. 2022 May-Jun;45(3):722-732. doi: 10.1080/07317115.2020.1769784. Epub 2020 Jun 16. Clin Gerontol. 2022. PMID: 32543295 - Executive dysfunction correlates with impaired functional status in older adults with varying degrees of cognitive impairment.
Pereira FS, Yassuda MS, Oliveira AM, Forlenza OV. Pereira FS, et al. Int Psychogeriatr. 2008 Dec;20(6):1104-15. doi: 10.1017/S1041610208007631. Epub 2008 Aug 27. Int Psychogeriatr. 2008. PMID: 18752698 - Cross-cultural adaptation, reliability and validity of the DAFS-R in a sample of Brazilian older adults.
Pereira FS, Oliveira AM, Diniz BS, Forlenza OV, Yassuda MS. Pereira FS, et al. Arch Clin Neuropsychol. 2010 Jun;25(4):335-43. doi: 10.1093/arclin/acq029. Arch Clin Neuropsychol. 2010. PMID: 20484096 - Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet].
Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Lin JS, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. PMID: 24354019 Free Books & Documents. Review. - The application of the principles of geriatrics to the management of the older person with cancer.
Balducci L, Beghe C. Balducci L, et al. Crit Rev Oncol Hematol. 2000 Sep;35(3):147-54. doi: 10.1016/s1040-8428(00)00089-5. Crit Rev Oncol Hematol. 2000. PMID: 10960797 Review.
Cited by
- Preliminary validation of the Virtual Kitchen Challenge as an objective and sensitive measure of everyday function associated with cerebrovascular disease.
Holmqvist SL, Jobson K, Desalme D, Simone SM, Tassoni M, McKniff M, Yamaguchi T, Olson I, Martin N, Giovannetti T. Holmqvist SL, et al. Alzheimers Dement (Amst). 2024 Feb 5;16(1):e12547. doi: 10.1002/dad2.12547. eCollection 2024 Jan-Mar. Alzheimers Dement (Amst). 2024. PMID: 38318469 Free PMC article. - Feasibility and preliminary efficacy of the LEAD trial: a cluster randomized controlled lifestyle intervention to improve hippocampal volume in older adults at-risk for dementia.
Koblinsky ND, Anderson ND, Ajwani F, Parrott MD, Dawson D, Marzolini S, Oh P, MacIntosh B, Middleton L, Ferland G, Greenwood CE. Koblinsky ND, et al. Pilot Feasibility Stud. 2022 Feb 9;8(1):37. doi: 10.1186/s40814-022-00977-6. Pilot Feasibility Stud. 2022. PMID: 35139918 Free PMC article. - Predictors of instrumental activities of daily living in community-dwelling older adults.
McDougall GJ, Han A, Staggs VS, Johnson DK, McDowd JM. McDougall GJ, et al. Arch Psychiatr Nurs. 2019 Oct;33(5):43-50. doi: 10.1016/j.apnu.2019.08.006. Epub 2019 Aug 20. Arch Psychiatr Nurs. 2019. PMID: 31711593 Free PMC article. - Dementia-Related Neuropsychological Testing Considerations in Non-Hispanic White and Latino/Hispanic Populations.
Burke SL, Naseh M, Rodriguez MJ, Burgess A, Loewenstein D. Burke SL, et al. Psychol Neurosci. 2019 Jun;12(2):144-168. doi: 10.1037/pne0000163. Epub 2019 Mar 11. Psychol Neurosci. 2019. PMID: 31649798 Free PMC article. - Rationale and protocol of the ENGAGE study: a double-blind randomized controlled preference trial using a comprehensive cohort design to measure the effect of a cognitive and leisure-based intervention in older adults with a memory complaint.
Belleville S, Moussard A, Ansaldo AI, Belchior P, Bherer L, Bier N, Bohbot VD, Bruneau MA, Cuddy LL, Gilbert B, Jokel R, Mahalingam K, McGilton K, Murphy KJ, Naglie G, Rochon E, Troyer AK, Anderson ND. Belleville S, et al. Trials. 2019 May 22;20(1):282. doi: 10.1186/s13063-019-3250-6. Trials. 2019. PMID: 31118095 Free PMC article.
References
- Bell-McGinty S, Podell K, Franzen M, Baird AD, Williams MJ. Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry. 2002;17:828–843. - PubMed
- Bertrand R, Willis SL, Sayer A. An evaluation of change over time in everyday cognitive competence among Alzheimer patients. Aging, Neuropsychology, and Cognition. 2001;8:192–212.
- Burton CL, Strauss E, Hultsch DF, Hunter MA. Cognitive functioning and everyday problem solving in older adults. Clinical Neurologist. 2006;20:432–452. - PubMed
- Cahn-Weiner DA, Malloy PF, Boyle PA, Marran M, Salloway S. Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clinical Neuropsychologist. 2000;14:187–196. - PubMed