Development of an activities of daily living scale to screen for dementia in an illiterate rural older population in India

Abstract

Objective: to develop a measure of activities of daily living appropriate for use in assessing the presence of dementia in illiterate rural elderly people in India. Design: identification of relevant items, pre-testing of items and refinement of administrative procedures and scoring in four successive groups of 30 subjects each, pilot testing in a group of 100 subjects comparable to those for whom the measure is intended, administration to a representative sample of 387 people aged 55 and older, and assessment of the reliability of the final measure. Setting and subjects: age-stratified random sample of older men and women in rural areas of Ballabgarh, Northern India Results: the original pool of 35 items covering mobility, instrumental and personal care activities was reduced to an 11-item unidimensional scale (to which an additional item on mobility was added) with internal consistency (Cronbach's a) = 0.82, perfect inter-and intra-rater reliability, test-retest reliability (intraclass correlation) = 0.82 (any disability) and 0.92 (unable to perform for 'mental' reasons). Women, older subjects, the totally illiterate and subjects with poorer cognitive function performed significantly more poorly (P Յ 0.02 for all). Product: a brief, reliable and valid activities of daily living measure, with norms, which is appropriate for use in assessing dementia in illiterate rural elderly people in India.

Functional Disability Profiles in Amnestic Mild Cognitive Impairment

“…For subjects with cognitive complaints, functional assessments can be complementary in improving the diagnostic specificity of cognitive assessments [7] and an alternative for screening cognitive impairment [35]. Our patients with md-aMCI had more impaired IADL items of DAD than the normal controls, and most of them presented deficits in 3 or more items.…”

The development of a semi-structured home interview (CHIF) to directly assess function in cognitively impaired elderly people in two cultures

“…We are encouraged that these results demonstrate its utility in these two populations from very different socioeconomic and cultural backgrounds. We propose that this approach of collecting information on functioning directly from participants may be a useful addition to other international studies of dementia but would require further validation in the populations to be studied including the selection of the appropriate items to reflect the culture and social circumstances of the study population (Fillenbaum et al, 1999). ROC curves for CHIF at both sites of dementia vs. non-dementia.…”

Adaptação transcultural e análise da confiabilidade do Southampton Assessment of Mobility para avaliar a mobilidade de idosos brasileiros com demência

“…Estima-se que sua incidência seja de 7,7 casos/mil habitantes, por ano 12 . A expansão deste grupo de pacientes requer o desenvolvimento de instrumentos de avaliação específicos para pessoas idosas com demência e, apesar de estabelecida a relação entre desempenho funcional motor e alterações cognitivas, observase uma escassez de instrumentos para avaliar a função motora de idosos com demência 13,14,15,16,17,18,19,20,21,22,23,24 .…”

“…A escolha do SAM fundamentou-se no interesse em termos disponíveis em nosso idioma um instrumento voltado para a avaliação da mobilidade de idosos com demência e por esse ser um instrumento simples e de fácil aplicação. Para Fillenbaum et al 15 , a mobilidade é um representante indireto de cuidados pessoais, interação social e atividades cognitivas.…”