Evaluating Distinctions in the Assessment of Late-Life Disability

Evaluating Distinctions in the Assessment of Late-Life Disability AbstractBackgroundBy including categories for accommodations and reduced frequency, to supplement earlier classifications of difficulty and dependence, a new 5-category functional scale has the potential to distinguish finer gradations in disability but the hierarchical nature and advantages of this scale over alternative scales are uncertain.MethodsUsing data from the National Health and Aging Trends Study (N = 7,609), we conducted a series of: cross-sectional analyses that focused on the hierarchical consistency of responses in the 5-category scale; and longitudinal analyses that focused on predictive accuracy for mortality and functional dependence, comparing the 5-category scale with three simpler scales, having only three or four categories.ResultsAlthough there was considerable variability across the seven functional activities, the prevalence of inconsistencies in the hierarchy of the 5-category scale (eg, reports difficulty but no accommodations) was relatively high. In addition, the predictive accuracy of the 5-category scale for mortality and functional dependence was only modestly better than that of the two 3-category scales and was comparable to that of the 4-category scale. Finally, when evaluated as summative disability scores, there was little difference in predictive accuracy between the 5-category scale and three alternative scales.ConclusionsDespite inconsistencies in its hierarchy, the 5-category scale is more effective in stratifying risk for mortality and functional dependence than the two 3-category scales but not the 4-category scale. When assessing changes over time, however, the addition of questions on accommodations and reduced frequency to those on difficulty and dependence, to form a summative disability score, offers little benefit and increases the burden of the assessment. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences Oxford University Press

Evaluating Distinctions in the Assessment of Late-Life Disability

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Publisher
Oxford University Press
Copyright
© The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
1079-5006
eISSN
1758-535X
D.O.I.
10.1093/gerona/glx022
Publisher site
See Article on Publisher Site

Abstract

AbstractBackgroundBy including categories for accommodations and reduced frequency, to supplement earlier classifications of difficulty and dependence, a new 5-category functional scale has the potential to distinguish finer gradations in disability but the hierarchical nature and advantages of this scale over alternative scales are uncertain.MethodsUsing data from the National Health and Aging Trends Study (N = 7,609), we conducted a series of: cross-sectional analyses that focused on the hierarchical consistency of responses in the 5-category scale; and longitudinal analyses that focused on predictive accuracy for mortality and functional dependence, comparing the 5-category scale with three simpler scales, having only three or four categories.ResultsAlthough there was considerable variability across the seven functional activities, the prevalence of inconsistencies in the hierarchy of the 5-category scale (eg, reports difficulty but no accommodations) was relatively high. In addition, the predictive accuracy of the 5-category scale for mortality and functional dependence was only modestly better than that of the two 3-category scales and was comparable to that of the 4-category scale. Finally, when evaluated as summative disability scores, there was little difference in predictive accuracy between the 5-category scale and three alternative scales.ConclusionsDespite inconsistencies in its hierarchy, the 5-category scale is more effective in stratifying risk for mortality and functional dependence than the two 3-category scales but not the 4-category scale. When assessing changes over time, however, the addition of questions on accommodations and reduced frequency to those on difficulty and dependence, to form a summative disability score, offers little benefit and increases the burden of the assessment.

Journal

The Journals of Gerontology Series A: Biomedical Sciences and Medical SciencesOxford University Press

Published: Oct 12, 2017

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