Factor Analysis of the Texas Functional Living Scale in an Outpatient Clinical Sample

Abstract

Objective Prior factor analysis of the Texas Functional Living Scale (TFLS), a performance-based measure of functional abilities, in a military veteran sample supported four factors discrepant from the published subscales. This study analyzed TFLS factor structure in a non-veteran clinical sample. Method Two hundred seventy adult outpatients completed the TFLS during neuropsychological evaluation. Principal axis factor analysis with oblique promax rotation was conducted with age and education effects partialed out. Results Parallel analysis indicated five factors for extraction that accounted for a combined 48% of the variance. The first factor independently explained 26% of the total variance. Inspection of factor loadings suggested the following factor interpretations: complex calculations/time, complex visual search, praxis, memory, and basic calculations/math concepts. Five items did not significantly load onto any of the factors. Conclusions Current results did not entirely correspond to the published subscales or prior results in a veteran sample. Further clarification of the TFLS factor structure is warranted.

The Influence of Processing Speed, Attention, and Inhibition on Texas Functional Living Scale Performance

“…Additionally, patients assumed to be “too impaired” or “functionally intact” may not have been given a TFLS during their evaluation, potentially skewing the current sample. However, the sample’s size and similar clinical presentation to past studies examining the TFLS ( Gonzalez et al., 2017 ; Lowe et al, 2020 ; Nguyen et al., 2019) suggest adequate generalizability of the current findings. Next, although the cognitive model proposed in the current study is grounded theoretically, the measures were limited to those available, resulting in an uneven number of measures used to construct each latent variable.…”

“…The TFLS contains 24 items intended to measure time and money management, communication skills, and memory. Although TFLS performance is assessed across five individual scales, including an additive Total score, factor analytic studies demonstrate support for the clinical utility of the Total score performance, as this was the only scale to consistently demonstrate adequate convergent and discriminant validity with other neurocognitive measures ( Gonzalez, Soble, Marceaux, & McCoy, 2017 ; Lowe, Nguyen, Copeland, & Linck, 2020 ). Earlier versions of the TFLS have demonstrated good sensitivity when measuring functional change among those diagnosed with Alzheimer’s disease ( Weiner, Fields, Hynan, & Cullum, 2008 ) and have demonstrated good discriminant validity when determining level of care among individuals diagnosed with dementia ( Weiner et al., 2007 ).…”