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Development, validity, and reliability of the General Activities of Daily Living Scale: A multidimensional measure of activities of daily living for older people

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Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.
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... The most widely used measure of disability is the ADL scale [17]. ADL are usually categorised as "basic activities of daily living" (BADL), which involve dressing, bathing or showering, eating, getting into or out of bed, using the toilet, and controlling urination and defecation, and "instrumental activities of daily living" (IADL), which include doing household chores, preparing hot meals, shopping, taking medications and managing money [22]. Dependence or the need for assistance with respect to at least one of these was defined as disability in daily activities [21]. ...
... We also found that depressive states are particularly intervening between CHEs and IADL. Compared to BADL, IADL includes more complex mobility [22], which means that people with IADL disability are more in need of emotional support. Therefore, it is necessary to improve community health services, pay attention to the mental health of those with CHEs, carry out early intervention, and improve health awareness and health level. ...
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Background Hunger is an important public health issue. This study aims to explore the impact of childhood hunger experiences (CHEs) on activities of daily living (ADL) disability and to discover the mediating role of depression on this correlation. Methods Data were derived from the China Health and Retirement Longitudinal Study 2011, 2013, 2015, 2018, and 2020. Depression was assessed using the Centre for Epidemiological Studies Depression Scale. ADL disability, basic ADL (BADL) disability and instrumental ADL (IADL) disability were assessed using the ADL scale. The relationships between CHEs, depression and ADL disability were estimated using probit methods, and the mediating effect of depression was estimated using the stepwise regression test and bootstrap methods. Results A total of 9,905 sample were included in the study. The study found that CHEs increased ADL disability by approximately 9.1% (β = 0.091, 95% CI: 0.028, 0.154), and increased the probability of IADL disability by approximately 8.0% (β = 0.080, 95% CI: 0.016, 0.144). CHEs increased ADL disability by approximately 29.8% (β = 0.298, 95% CI: 0.202, 0.393) in samples under 60 years of age. CHEs indirectly increased ADL (β = 0.062, 95% CI: 0.000, 0.124) by increasing the probability of depression. Conclusion CHEs predicted ADL disability, and depression mediated this correlation. There is a need to focus on the impact of CHEs on mental and physical health. In particular, focusing on mental health is necessary to prevent impairment of physical functioning.
... Todos os participantes realizarão teleconsulta por telefone para avaliação de possíveis contraindicações para os seguintes exames complementares: creatinina e ureia séricos; creatinina e proteínas totais na urina, microalbuminúria e exame qualitativo de urina; espirometria com difusão pulmonar para o monóxido de carbono (CO 2 ) sem prova broncodilatadora; ergoespirometria em esteira rolante (18) atividades instrumentais de vida diária aferidas pela escala de Lawton e Brody de atividades instrumentais de vida diária a partir de 12 meses; (19) função e força muscular avaliadas pela Strength, Assistance with Walking, Rising from a Chair, Climbing Stairs, and Falls (SARC-F) a partir de 12 meses; (20) dispneia aferida pela escala modificada de dispneia do Medical Research Council (MRC) a partir de 12 meses; (21) qualidade de vida relacionada à saúde avaliada pelo questionário EuroQol 5 Dimensions 3 Levels (EQ-5D-3L) a partir de 12 meses; (22,23) variáveis ergoespirométricas a partir de 12 meses: consumo direto de oxigênio, consumo máximo de oxigêncio (VO 2 pico), razão volume minuto/produção de CO 2 (VE/VCO 2 slope) e eficiência de captação de oxigênio (OUES -Oxygen Uptake Efficiency Slope); variáveis espirométricas a partir de 12 meses: capacidade vital (CV), volume expiratório forçado no primeiro segundo (VEF1) e VEF1/CV; padrões radiológicos de fibrose pulmonar aferidos por tomografia de tórax de alta resolução a partir de 12 meses; padrões radiológicos relacionados às sequelas de miocardite aguda aferidos por ressonância magnética cardíaca com mapas paramétricos ponderados em T1 e T2 e por meio da técnica do realce tardio a partir de 12 meses; padrões radiológicos de sarcopenia aferidos por tomografia de tórax de alta resolução a partir de 12 meses; alterações de função ou estrutura renal avaliados por ressonância magnética e exames laboratoriais; e eventos cardiovasculares maiores (infarto não fatal, acidente vascular cerebral não fatal e insuficiência cardíaca aguda) e eventos tromboembólicos (trombose venosa profunda ou embolia pulmonar) após a alta hospitalar. O protocolo de coleta de dados referentes aos exames coletados encontra-se descrito no Material Suplementar. ...
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RESUMO Fundamento: As evidências acerca das sequelas a longo prazo após internação por síndrome do desconforto respiratório agudo por COVID-19 ainda são escassas. Objetivo: Avaliar alterações nas funções pulmonar, cardíaca e renal e na qualidade de vida após internação por síndrome do desconforto respiratório agudo secundária à COVID-19. Métodos: Trata-se de estudo multicêntrico, caso-controle, incluindo 220 participantes. Os casos serão definidos como pacientes hospitalizados por síndrome do desconforto respiratório agudo devido à COVID-19. No Grupo Controle, serão selecionados indivíduos sem histórico de hospitalização nos últimos 12 meses ou sintomas a longo prazo de COVID-19. Todos os indivíduos serão submetidos à espirometria pulmonar com teste de difusão pelo monóxido de carbono, tomografia de tórax, ressonância magnética cardíaca e renal com gadolínio, ergoespirometria, creatinina sérica e urinária, proteínas totais e microalbuminúria urinária, além de questionários de qualidade de vida. Os casos serão avaliados 12 meses após a alta hospitalar e os controles, 90 dias após a inclusão no estudo. Para todas as análises estatísticas, será assumido como significativo o valor p < 0,05. Resultados: O desfecho primário do estudo foi definido com a capacidade de difusão pulmonar aferida para o monóxido de carbono a partir de 12 meses. Os demais parâmetros das funções pulmonar, cardíacas e renal e da qualidade de vida foram definidos como desfechos secundários. Conclusão: Este estudo visa determinar as sequelas a longo prazo nas funções pulmonar, cardíaca e renal e na qualidade de vida de pacientes internados por síndrome do desconforto respiratório agudo devido à COVID-19 na população brasileira.
... The primary outcome of the study is the pulmonary diffusing capacity for carbon monoxide (DLCO) measured after 12 months. The following were considered secondary outcomes: physical-functional capacity measured by the modified Barthel index after 12 months; (18) instrumental activities of daily living measured by the Lawton and Brody scale of instrumental activities of daily living from 12 months onward; (19) muscle function and strength assessed by Strength, Assistance with Walking, Rising from a Chair, Climbing Stairs, and Falls (SARC-F) at 12 months of age; (20) dyspnea measured by the modified Medical Research Council (MRC) dyspnea scale from 12 months of age; (21) health-related quality of life assessed using the EuroQol 5 Dimensions 3 Levels questionnaire (EQ-5D-3L) from 12 months onward; (22.23) ergospirometric variables from 12 months onward: direct oxygen consumption, maximum oxygen consumption (VO 2 peak), minute volume/CO 2 production ratio (VE/VCO 2 slope) and oxygen uptake efficiency (OUES -Oxygen Uptake Efficiency Slope); spirometric variables from 12 months onward: vital capacity (VC), forced expiratory volume in one second (FEV1) and FEV1/VC; and radiological patterns of pulmonary fibrosis assessed by high-resolution tomography of the chest from 12 months onward; radiological patterns related to the sequelae of acute myocarditis assessed by cardiac magnetic resonance imaging with T1-and T2-weighted parametric maps and by means of the delayed enhancement technique from 12 months onward; radiological patterns of sarcopenia assessed by high-resolution tomography of the chest from 12 months onward; changes in renal function or structure assessed by magnetic resonance imaging and laboratory tests; and major cardiovascular events (non-fatal infarction, non-fatal stroke, acute heart failure) and thromboembolic events (deep venous thrombosis, pulmonary embolism) after hospital discharge. The data collection protocol for the exams collected is described in the Supplementary Material. ...
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Rationale: Evidence about long-term sequelae after hospitalization for acute respiratory distress syndrome due to COVID-19 is still scarce. Purpose: To evaluate changes in pulmonary, cardiac, and renal function and in quality of life after hospitalization for acute respiratory distress syndrome secondary to COVID-19. Methods: This will be a multicenter case-control study of 220 participants. Eligible are patients who are hospitalized for acute respiratory distress syndrome due to COVID-19. In the control group, individuals with no history of hospitalization in the last 12 months or long-term symptoms of COVID-19 will be selected. All individuals will be subjected to pulmonary spirometry with a carbon monoxide diffusion test, chest tomography, cardiac and renal magnetic resonance imaging with gadolinium, ergospirometry, serum and urinary creatinine, total protein, and urinary microalbuminuria, in addition to quality-of-life questionnaires. Patients will be evaluated 12 months after hospital discharge, and controls will be evaluated within 90 days of inclusion in the study. For all the statistical analyses, p < 0.05 is the threshold for significance. Results: The primary outcome of the study will be the pulmonary diffusing capacity for carbon monoxide measured after 12 months. The other parameters of pulmonary, cardiac, and renal function and quality of life are secondary outcomes. Conclusion: This study aims to determine the long-term sequelae of pulmonary, cardiac, and renal function and the quality of life of patients hospitalized for acute respiratory distress syndrome due to COVID-19 in the Brazilian population.
... In addition, it was based on the studies found in the literature review and used as its theoretical foundation the categories of the Katz and Lawton scale, which assess the general daily life activities, and the empirical elements of professional practice. The classification of the items incorporated the main care to be provided by nurses to informal caregivers to ensure the transition to hospital discharge and continued care at home, as shown in Figure 2 (16). Nursing checklist to provide guidance to informal caregivers regarding home care during the hospital discharge transition Care Guidelines ...
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Introduction: The use of pre-discharge tools enables the nursing team to guide informal caregivers, promoting continued care at home, which can minimize readmissions. Objective: To develop and validate a checklist to support the nursing team in guiding informal caregivers regarding home care during the discharge transition process. Materials and Methods: This is a methodological study, submitted to 14 nurse judges, who evaluated a checklist on care guidelines for informal caregivers in the hospital discharge transition. The study was performed in three stages: A literature review, the development of the checklist, and validation using the Delphi technique, which was conducted from February 2022 to January 2023, and the data was treated using scale reliability analysis, a content validity index, and an intraclass correlation coefficient. Results: The checklist was comprised of 10 domains: Hygiene and comfort; tracheostomy; oxygen therapy; nutrition; indwelling urinary catheter; ostomies; dressings; risk of falls; medication; returns and referrals, totaling 32 guidelines for informal caregivers. The checklist was submitted to two validation stages and, after implementing the changes suggested by the judges, a content validity index of 100% agreement was obtained between the evaluators, with a Cronbach’s Alpha of 0.84 and an intraclass correlation index of 0.80. Conclusions: The checklist presents good reliability, intraclass correlation, and content validation, and can be applied in professional practice and scientific settings regarding the transition to hospital discharge of critically ill patients, helping to promote continued care at home.
... Dependence is assessed using the General Activities of Daily Living Scale. [6] Depression was evaluated among the elderly by the Geriatric Depression Scale. [7] The third section contained questions about the family members and the type of abuse and neglect faced by older people. ...
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Background Elder abuse is a multidimensional problem of public importance. According to the World Health Organization (WHO), 16% of older people were victims of elder abuse. A study conducted by HelpAge India in 2018 showed that Mangaluru ranks the highest in elder abuse (47%). Given the scarce literature, this study sought to determine the prevalence of elder abuse and its associated sociodemographic factors. Material and Methods A community-based cross-sectional study was conducted among the senior population in the rural and urban field practice a medical college in Mangaluru for one and a half years. The sample size was 280. Results Most of the study population was in the age group of fewer than 75 years (75.4%), with 50.4% females, 60% Hindus, 56.4% married, 39.3% illiterate, and 88.9% of them retired. The prevalence of elder abuse was 44.6% (rural = 50.7% and urban = 38.6%). Binary logistic regression showed that elder abuse was statistically significant among the unemployed, extended family members, and staying with children. Conclusions The study brings to light the sociodemographic factors that play a role in detecting elder abuse. It also shows the importance of awareness of elder mistreatment among older people. These elements must be considered for implementing and enforcing laws and legislation to help curb elder abuse.
... The secondary outcomes will be assessed four times: at three, six, nine, and 12 months after hospital discharge. They include: 1 -Quality of life assessed by the EQ-5D-3L (at 3, 6, and 9 months); 2 -Death up to 12 months after discharge; 3 -Major cardiovascular events: cardiovascular death, non-fatal acute myocardial infarction, and non-fatal stroke 12 months after discharge; 4 -Incidence of non-planned early (30 days) or late (31-180 days) rehospitalization; 5 -Prevalence of long-term symptoms: dyspnea, cough, fatigue, muscle weakness, chest discomfort, joint pain, anosmia, hair loss, difficulty concentrating, and sleep disorder; 6 -Cognitive impairment assessed using the Telephone Interview for Cognitive Status-modified (TICS-m); 17 7 -Anxiety and depression symptoms estimated by the Hospital Anxiety and Depression Scale (HADS); 18 8 -Post-traumatic stress disorder according to the Impact of Event Scale-6 (IES-6); 19 9 -Functional physical status assessed by the modified Barthel index; 20 10 -New disabilities in instrumental activities of daily living assessed by the Lawton & Brody scale (any impairment, moving from independent to partially dependent or from partially dependent to totally dependent, in at least one of the following domains: telephone use, transportation, shopping, responsibility for own medications, and ability to handle finances) relative to one month before COVID-19; 21 11 -Return to work or education; and 12 -Symptomatic SARS-CoV-2 reinfection (defined as the recurrence of COVID-19-like symptoms confirmed by a positive RT-PCR or antigen test for SARS-CoV-2 more than 90 days after primary infection). Positive RT-PCR test for SARS-CoV-2 with nasopharyngeal swab or positive antigen test for SARS-CoV-2 with nasopharyngeal swab up to 14 days prior to index hospitalization ...
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Introduction Mild cognitive impairment (MCI) and Alzheimer's disease (AD) lead to decline in performance in activities of daily living (ADLs). Multiple questionnaires assess this construct among older adults. The objective of this study was to review existing literature studying psychometric properties of questionnaires assessing performance in ADLs of older adults living with MCI and AD specifically. Methods A systematic review was conducted across Medline, CINAHL and PsychINFO using a combination of keywords related to ADLs, psychometrics, MCI and AD. Studies were included if they met the following criteria: assessments of performance of ADLs for older adults living with AD or MCI, reporting a minimum of one measurement property (e.g. internal consistency), primary research articles, published before June 2023 in English or French. Data extraction and analysis were conducted by two researchers. The methodological quality of psychometric properties was assessed using the COSMIN checklist. Consumer and Community Involvement No consumer or community involvement occurred. Results A total of 2539 articles were screened and filtered down to 50 articles including 24 questionnaires respecting inclusion criteria. Of these questionnaires, the three most validated were the Amsterdam Instrumental activities of daily living, the disability assessment for dementia (DAD), and the Bayer ADL scale. Overall, for these three questionnaires, internal consistency, reliability and structural validity were the most studied psychometric properties while criterion validity and hypothesis testing were the least. Conclusion This study reveals the Amsterdam IADLs as the most validated questionnaire across psychometric properties and the DAD as the most validated across languages. Considering the increasing prevalence of older adults with MCI or AD, questionnaires established on strong measurement properties are valuable tools to evaluate decline in ADL performance and plan suitable interventions. This review provides evidence for clinicians and researchers for the selection of questionnaires to evaluate this population. PLAIN LANGUAGE SUMMARY Cognitive impairment affects memory and thinking. It makes tasks like dressing, bathing and eating harder. Health‐care workers use questionnaires to find out where someone struggles. This helps them plan better care. We reviewed questionnaires for older adults with memory and thinking problems. We found good ones that give important information. Using these questionnaires helps health‐care workers support people with daily tasks. This study suggests testing the questionnaires more to improve them.
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This study aimed to develop a scale to assess functional independence (Functional and Expressive Independence Scale – EIFE) and investigate its validity evidence based on content and internal structure. The construction of the items followed five steps: review of the functional independence scales ( n = 50 items); creation of new items ( n = 79); evaluation by six expert judges (57 suggestions); and two pilot studies (10 caregivers and 2 participants with low education). The initial version contained 122 items and was subjected to reliability and exploratory factor analysis using a sample of 241 caregivers. The EIFE now consists of 95 items, divided into eight subscales, with one to four internal dimensions. The analyses showed good fit indices and factor structure replicability. The internal consistency of the subscales ranged from .83 to .94. In conclusion, the EIFE assesses functionality and emotional expression and can be used in the Brazilian population.
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Background: Medium-chain fatty acids (MCFAs) and docosahexaenoic acid (DHA) could affect the occurrence of mild cognitive impairment (MCI). β-hydroxybutyrate (BHB), mitochondrial DNA copy number (mtDNAcn) and mitochondrial DNA (mtDNA) deletions might be their potential mechanisms. This study aimed to explore the relationship between MCFAs, DHA and MCI, and potential mechanisms. Methods: This study used data from Tianjin Elderly Nutrition and Cognition (TENC) cohort study, 120 individuals were identified with new onset MCI during follow-up, 120 individuals without MCI were selected by 1:1 matching sex, age, and education levels as the control group from TENC. Conditional logistic regression analysis and mediation effect analysis were used to explore their relationship. Results: Higher serum octanoic acid levels (OR: 0.633, 95% CI: 0.520, 0.769), higher serum DHA levels (OR: 0.962, 95% CI: 0.942, 0.981), and more mtDNAcn (OR: 0.436, 95% CI: 0.240, 0.794) were associated with lower MCI risk, while more mtDNA deletions was associated with higher MCI risk (OR: 8.833, 95% CI: 3.909, 19.960). Mediation analysis suggested that BHB and mtDNAcn, in series, have mediation roles in the association between octanoic acid and MCI risk, and mtDNA deletions have mediation roles in the association between DHA and MCI risk. Conclusion: Higher serum octanoic acid and DHA levels were associated with lower MCI risk. Octanoic acid could affect the incidence of MCI through BHB, then mitochondria function, or through mitochondria function, or directly. Serum DHA level could affect the incidence of MCI through mitochondria function, or directly.
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Objective: The aim of this paper was to present the results of the first stage of cross-cultural adaptation of the Functional Activities Questionnaire (FAQ). Methods: The tool was subjected to translation and re-translation, and the test-retest reliability of a proposed version for use in Brazil was analyzed. Results: Of the 548 questionnaire respondents, a convenience sample of 68 informants was selected for retesting. Internal consistency was measured by Cronbach's alpha (0.95) while test-retest reliability was assessed using intra-class correlation (0.97). The findings have shown that FAQ is brief - averaging seven minutes to apply, easily understood and has good intra-rater test-retest reliability. Conclusion: Our results suggest this adapted version of the FAQ is a reliable and stable tool which may be useful for assessing function in Brazilian elderly. Notwithstanding, the version should be subjected to further analysis with the aim of reaching functional equivalence.
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O projeto SABE (Saúde, bem-estar e envelhecimento) foi coordenado pela Organização Pan-Americana de Saúde com o objetivo de coletar informações sobre as condições de vida dos idosos (60 anos e mais) residentes em áreas urbanas de metrópoles de sete países da América Latina e Caribe - entre elas, o Município de São Paulo - e avaliar diferenciais de coorte, gênero e socioeconômicos com relação ao estado de saúde, acesso e utilização de cuidados de saúde. Por meio de questionário e processo amostral padronizados foram entrevistadas 2.143 pessoas. Encontrou-se que as mulheres são maioria, os imigrantes eram 8,7%, 62,6% viveram por cinco anos ou mais na área rural até os quinze anos de vida. Dos idosos, 13,2% viviam sós, sendo que esse valor aumentou com a idade e no sexo feminino. Em relação ao estado mental, encontrou-se, pelo Mini Exame do Estado Mental (MEEM), 6,9% de deterioração cognitiva e 18,1% de depressão, segundo a Escala de Depressão Geriátrica. As auto-avaliações de saúde mostram que 53,8% dos entrevistados consideraram a sua saúde regular ou má. Dentre as doenças mais freqüentes estavam a hipertensão (53,3%); artrite/artrose/reumatismo, 31,7%; e diabetes, 17,9%. A grande maioria dos idosos não apresentou dificuldades nas atividades básicas de vida diária (80,7%), e entre aqueles que apresentaram, a maioria tinha dificuldades em uma ou duas atividades. Foram apresentados dados dos arranjos domiciliares encontrados, do acesso e utilização de serviços de saúde, e relativos à renda e condição de trabalho. Conclui-se que as condições de saúde são preocupantes, assim como a insuficiência do sistema de seguridade social.
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This study involved the development and per- formance assessment of a cultural adaptation of the Katz scale of independence in activities of daily living, translated into Portuguese in Bra- zil. Two translations and two back-translations of the items were analyzed by experts in order to decide on the final version. Operational equiv- alence was assessed in a pilot study. The reli- ability and internal consistency of the adapted version were assessed by retesting 156 patients on the same day or 7 days after the first inter- view. Cultural equivalence was achieved after resolving subtle differences in some items. The final version was considered easy to understand and use. Chance-corrected agreement (weighted kappa) was 0.91. Cronbach's alpha ranged from 0.80 to 0.92. Conclusions: a Portuguese version of the Katz scale of independence in activities of daily living, thoroughly developed and test- ed, proved equivalent to the original version in English. The items were internally consistent and the rates were reliable.