Instrumental Activities Of Daily Living Questionnaire Research Articles

Detecting functional decline from normal aging to dementia: Development and validation of a short version of the Amsterdam IADL Questionnaire

IntroductionDetecting functional decline from normal aging to dementia is relevant for diagnostic and prognostic purposes. Therefore, the Amsterdam IADL Questionnaire (A-IADL-Q) was developed: a 70-item proxy-based tool with good psychometric properties. We aimed to design a short version while preserving its psychometric quality. MethodsStudy partners of subjects (n = 1355), ranging from cognitively normal to dementia subjects, completed the original A-IADL-Q. We selected the short version items using a stepwise procedure combining missing data, Item Response Theory, and input from respondents and experts. We investigated internal consistency of the short version and concordance with the original version. To assess its construct validity, we additionally investigated concordance between the short version and the Mini–Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD). Finally, we investigated differences in instrumental activities of daily living (IADL) scores between diagnostic groups across the dementia spectrum. ResultsWe selected 30 items covering the entire spectrum of IADL functioning. Internal consistency (0.98) and concordance with the original version (0.97) were very high. Concordance with the MMSE (0.72) and DAD (0.87) scores was high. IADL impairment scores increased across the spectrum from normal cognition to dementia. DiscussionThe A-IADL-Q short version (A-IADL-Q-SV) consists of 30 items and has maintained the psychometric quality of the original A-IADL-Q. As such, the A-IADL-Q-SV is a concise measure of functional decline.

Does prospective memory influence quality of life in community-dwelling older adults?

Older adults commonly experience declines in prospective memory, which describes one’s ability to “remember to remember,” and can adversely affect instrumental activities of daily living and healthcare compliance. However, the extent to which prospective memory failures may influence quality of life in typically aging older adults is not well understood. One-hundred and four community-dwelling older Australians (aged 50 to 82 years) were administered a comprehensive, neuropsychological battery that included the Memory for Intentions Screening Test (MIST), Prospective and Retrospective Memory Questionnaire (PRMQ), Instrumental Activities of Daily Living Questionnaire (IADLQ), and World Health Organization Quality of Life-8 (WHOQOL-8). Multiple regressions controlling for negative affect, medical comorbidities, and other neurocognitive functions revealed an interaction between prospective memory and instrumental activities of daily living in the concurrent prediction of quality of life. Among the 39 older adults who reported multiple problems on the IADLQ, lower performance-based prospective memory (MIST) and higher self-reported prospective memory failures in daily life (PRMQ) were significantly associated with lower quality of life (WHOQOL-8). Conversely, no significant associations were observed between prospective memory and quality of life in the 65 participants without IADL problems. Prospective memory difficulties adversely impact quality of life in community-dwelling older adults who experience problems independently managing their instrumental activities of daily living. These findings extend prior literature showing that prospective memory plays a unique role in the real-world outcomes of older adults and clinical populations and highlight the need to develop effective strategies to enhance prospective memory functioning in these vulnerable groups.

The sensitivity to change over time of the Amsterdam IADL Questionnaire©

IntroductionThis study aimed to investigate the sensitivity to change over time of a new informant-based instrument to assess instrumental activities of daily living (IADL) during the course of dementia: the Amsterdam IADL Questionnaire© (A-IADL-Q). MethodsParticipants (n = 102) were patients and their informants who visited the Alzheimer Center of the VU University Medical Center. Linear mixed models with random effects were used to relate longitudinal change on the A-IADL-Q to diagnosis and to longitudinal change in cognitive measures. ResultsWe found longitudinal change on the A-IADL-Q to differ between diagnosis (P = .003), with dementia patients showing the fastest rate of decline (P < .001). In addition, we found longitudinal change on the A-IADL-Q to be related to longitudinal change in cognitive measures (global cognition: P < .001; memory: P = .024; executive functioning: P = .028). DiscussionFindings indicate the A-IADL-Q is sensitive to change over time in IADL functioning and can be used in evaluating treatment effects and assessing individual disease progress.

Validation of the Amsterdam IADL Questionnaire©, a New Tool to Measure Instrumental Activities of Daily Living in Dementia

Background: This study describes the validation of a new instrument measuring instrumental activities of daily living (IADL), the Amsterdam IADL Questionnaire© (a registered copyright of the Alzheimer Center of the VU University Medical Center). This informant-based tool aimed at detecting IADL problems in incipient dementia was previously found to have a high internal consistency and test-retest reliability. Methods: Patients and their informants who visited the Alzheimer Center of the VU University Medical Center were included in this study. Item response theory was used to estimate the individuals' trait levels as a measure of IADL disability. Construct validity was tested by correlating estimated trait levels with clinical and demographic measures using Pearson's or Kendall's τ correlation coefficients. Additionally, estimated trait levels between patients with and without dementia and between patients with early- and late-onset dementia were compared using independent t tests. Results: A total of 206 informants of patients completed the Amsterdam IADL Questionnaire. The correlations between estimated trait levels and other measures were in concordance with previously formed hypotheses. Patients diagnosed with dementia (n = 93) had higher estimated trait levels than patients without dementia (n = 96), Cohen's effect size, d = 1.04, t(187) = 7.1, p < 0.001. We found no differences between early- and late-onset dementia patients. Conclusions: Results suggest that the Amsterdam IADL Questionnaire is a reliable and valid instrument in the evaluation of dementia.

Instrumental activities of daily living in Parkinson's disease dementia as compared with Alzheimer's disease: Relationship to motor disability and cognitive deficits: A pilot study

ObjectiveOur objective was to assess which clinical factors contribute most to the impairment of instrumental activities of daily living (IADL) in patients with dementia in Parkinson's disease (PDD) as compared to age- and dementia duration-matched patients with Alzheimer's disease (AD). MethodsEighteen consecutive subjects (16 men, 2 women) with PDD and 30 age- and dementia duration-matched subjects with AD (13 men, 17 women) were recruited. The groups were not matched for their Mini-Mental Status Examination (MMSE) score. Neuropsychiatric, cognitive and motor data were collected in a routine clinical setting using the MMSE, four brief tests of the seven minute screen (i.e. the Benton Temporal Orientation, Grober and Buschke's enhanced cued recall, verbal fluency, and the clock drawing test), the Neuropsychiatric Inventory, a modified version of the Hoehn and Yahr scale and a Czech modified version of Lawton's IADL questionnaire. The IADL scores were correlated with clinical variables in each group. ResultsThere were no differences in IADL abilities between both groups. A significant association was found between IADL and cognitive impairment as measured by screening tests in the AD group. In the PDD group, IADL scores were particularly correlated with PD duration (r=−0.73, p<0.01) and the Hoehn and Yahr score (r=−0.59, p<0.01). ConclusionOur pilot study results show that motor deficits remain the major contributor to IADL impairment in PDD.

Evaluation of a long-term community based rehabilitation program for adult stroke survivors

To evaluate the functional status, leisure activity and satisfaction in adult stroke survivors participating in a community rehabilitation program, and to compare these outcomes with stroke survivors not attending any program. Subjects included in the study were survivors of a first stroke that received inpatient rehabilitation and were living at home at least one year post onset. Twenty seven were participants in a community rehabilitation program and 56 were non-participants. The outcome measures were the Stroke impact Scale (SIS), Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), and the Life-Satisfaction questionnaire (Li-Sat-9). The results revealed severe stroke impact and low functioning in activities of daily living in the participant group, yet the level of participation in leisure activities improved significantly after attending the program (t=-8.1, p=0.000). The comparison with the non participant group revealed that participants were even more disabled in basic activities of daily living (as measured by the FIM) than non-participants (t=-3.1, p=0.004). However, the satisfaction rates of the participants were significantly higher than non participants from "life as a whole" and from their leisure situation (p<0.05). Stroke survivors participating in a community based rehabilitation program did not show an advantage in terms of disability levels over non-participants. However, their activity level increased due to the program and their satisfaction scores were higher than non-participants.

Activities, participation and satisfaction one-year post stroke

Purpose. To evaluate the chronic consequences of stroke in terms of activity limitations, restricted participation and dissatisfaction from life, and the relationship between these variables, in stroke survivors living in the community one-year post onset.Method. A total of 56 stroke patients (mean age: 57.7) who completed an in-patient rehabilitation programme, were evaluated one-year post onset in their homes, using the following instruments: Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), a work questionnaire, Life-Satisfaction Questionnaire (Li-Sat 9) and the Geriatric Depression Scale (GDS).Results. One year post stroke onset the mean FIM motor score was 75.88 (max score: 91), yet more than 50% of the sample still required assistance (usually mild to moderate) in dressing, bathing and use of stairs. The majority of the sample required full assistance in some IADL domains, notably meal preparation (77%), housekeeping (70%) and laundry (82%). Only one subject returned to paid employment and the mean activity level (ACS), representing the percentage of leisure and IADL activities retained from before stroke, was 42.8%. Satisfaction ratings were generally low but varied between domains. Only 39% were satisfied from ‘life as a whole’. The lowest satisfaction rates were noted for ‘vocational situation’ (14%), ‘leisure situation’ (34%) and ‘ability in self-care’ (43%), whereas the satisfaction rate from family life was high (84%). Significant correlations were found between overall life satisfaction scores and the overall FIM motor, IADLq, and ACS scores (Pearson r values: 0.32, 0.48 and 0.57, respectively). Activity level was found to be a significant predictor of satisfaction (p = 0.007) beyond that accounted for by demographic variables and depression.Conclusions. Stroke survivors dwelling in the community demonstrate long-standing dissatisfaction one-year post onset, correlating with activity limitation and restricted participation. The findings present a compelling need for rehabilitation services with a focus on participation in IADL and leisure activities, in order to improve the satisfaction of this population.