Advanced Instrumental Activities of Daily Living (AIADL) Assessment for Older Adults

Abstract Description

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Authors (including presenting author) :

Lai FHY(1), Tong AYC(2), Chan AWH(3), Fung AWT(4), Yan EWH(5), Yu KKY(6)

Affiliation :

(1)Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, (2) Occupational Therapy Department, West Kowloon General Out-patient Clinic,(3)Occupational Therapy Department, Tai Po Hospital, (4)Department of Applied Social Sciences, The Hong Kong Polytechnic University, (5)Occupational Therapy Department, Kowloon Hospital, (6)The Salvation Army Tai Po Integrated Service for Senior Citizens

Introduction :

Instrumental activities of daily living (IADL) are the skills and abilities a person needs to perform the day-to-day tasks associated with an independent lifestyle. More modernized IADL items, such as use of smart phones, use of stored value smart cards and making electronic payments via mobile apps, are common in daily living nowadays.

Objectives :

This study aimed to refine an Advanced Instrumental Activities of Daily Living (AIADL) assessment, taking into consideration these updated elements which are important to daily living of our older adults in the community today. One item on use of smart phone is added and the concept in using of smart card for money management is supplemented to the instrument.

Methodology :

Totally four hundred subjects were involved in this validation study of Advanced Instrumental Activities of Daily Living (AIADL) assessment. One hundred home-living subjects were recruited for the test-retest reliability analysis. Another 200 functionally independent subjects (100 from hostels for the elderly and 100 living at home) were recruited for factor analysis and validity testing. Moreover, one hundred subjects from care-and-attention (C&A) homes who needed environment support and assistance to their daily functioning were recruited for construct validity testing using the known-groups method.

Result & Outcome :

The AIADL assessment showed good test-retest reliability, with an intra-class correlation coefficient (ICC) of .88 (with individual item ICCs ranging from .86 to .92 (95% CI: .84–.95)), and good to excellent internal consistency (Cronbach’s alpha = .94). Through exploratory factor analysis, the AIADL assessment yielded a two-factors structure: “Home Living and Management” and “Community Living”. Moreover, the daily function of individual older adults was assessed by Modified Barthel Index. The AIADL assessment showed significant correlation with MBI with r = .82, p < .05. A one-way ANOVA was conducted to analyze whether there was any difference between the three groups of subjects. The validity analysis using the known-groups method was followed by a logistic regression. A high overall accuracy of prediction (88.52%) of their residence was noted. Moreover, the correlation coefficient between AIADL assessment scores and known group was .85. The AIADL assessment was shown to be a valid and reliable instrument for identifying a person’s ability to live independently in the community.