Skip to main content
Log in

Functional ability among elderly people in three service settings: The discriminatory power of a new functional ability scale

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

The purpose is to assess the discriminatory power of the Avlund scales: (1) by assessing the ability of the scales to discriminate between three different populations of elderly people, and (2) by studying groups with a poor fit between use of formal home care and functional ability. The study included (A) all residents in new sheltered housing facilities (response rate 68%, n=102), (B) a random sample of users of home care (response rate 67%, n=435), and (C) a random sample of individuals not using home care (response rate 74%, n=501). All participants were 60+ years old. Data were collected by personal interviews (group A) and by postal questionnaires (group B and C). Functional ability was measured by The Avlund Mob–T scale about tiredness related to mobility and the Mob–H scale about need of help to mobility. Both scales were able to distinguish the three sub-populations. The whole range of the Mob–T scale was used in all three sub- populations, and the whole range of the Mob–H scale was used among the oldest residents and the oldest users of home care. A small group of well-functioning users of home care (n=52) was characterized by good self-rated health, good hearing, vision and memory abilities; they gave more help to others, had higher social participation, and lived alone (only the women). A somewhat lager group of poor functioning non-users of home care (n=266) had the opposite characteristics. In addition, they were older, had a poor social network and poor social support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Guralnik JM, Seeman TE, Tinetti ME, Nevitt MC, Berkman LF. Validation and use of performance measures of functioning in a non-disabled older population: MacArthur Studies of Successful Aging. Aging Clin Exp Res 1994; 6: 410-419.

    Google Scholar 

  2. Berkman LF, Seeman TE, Albert M, et al. High, usual and impaired functioning in community-dwelling older men and women: Findings from the MacArthur Foundation Research Network on Successful Aging. J Clin Epidemiol 1993; 46: 1129-1140.

    Google Scholar 

  3. Fried LP, Herdman SJ, Kuhn KE, Rubin G, Turano K. Preclinical disability. Hypotheses about the bottom of the iceberg. J Aging Health 1991; 3: 285-300.

    Google Scholar 

  4. Avlund K, Davidsen M, Schultz-Larsen K. Changes in functional ability from age 70 to 75: A Danish longi-tudinal study. J Aging Health 1995; 7: 254-282.

    Google Scholar 

  5. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW, Cleveland MA. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA 1963; 185: 914-919.

    Google Scholar 

  6. Pfeiffer E, Johnson TM, Chiofolo RC. Functional assessment of elderly subjects in four service settings. J Am Geriatr Soc 1981; 29: 433-437.

    Google Scholar 

  7. Pfeiffer BA, McClelland T, Lawson J. Use of the Functional Assessment Inventory to distinguish among the rural elderly in five service settings. J Am Geriatr Soc 1989; 37: 243-248.

    Google Scholar 

  8. Thorsen H, McKenna SP, Gottschalck L. Perceived health in three groups of elderly people. A validity study of the Danish version of the Nottingham Health Profile. Dan Med Bull 1995; 42: 105-108.

    Google Scholar 

  9. Hall RGP, Channing DM. Age, pattern of consultation, and functional disability in elderly patients in one general practice. BMJ 1990; 301: 424-428.

    Google Scholar 

  10. Avlund K, Schultz-Larsen K, Davidsen M. Tiredness in daily activities at age 70 as a predictor of mortality during the next 10 years. J Clin Epidemiol 1998; 51: 323-333.

    Google Scholar 

  11. Holstein BE. The elderly policy in Holbaek evaluated by 1500 citizens, users and sta.-members. (In Danish). Copenhagen: Institute of Social Medicine, University of Copenhagen, 1993.

    Google Scholar 

  12. Avlund K, Kreiner S, Schultz-Larsen K. Functional ability scales for the elderly. A validation study. Eur J Public Hlth 1996; 6: 35-42.

    Google Scholar 

  13. Avlund K, Schultz-Larsen K. What do 70-year-old men and women actually do? And what are they able to do? From the Glostrup survey in 1984. Aging Clin Exp Res 1991; 3: 39-49.

    Google Scholar 

  14. Avlund K, Kreiner S, Schultz-Larsen K. Construct validation and the Rasch Model: Functional ability of healthy elderly people. Scand J Soc Med 1993; 21: 233-245.

    Google Scholar 

  15. Avlund K, Schroll M, Davidsen M, Løvborg B, Rantanen T. Maximal isometric muscle strength and functional ability in daily activities among 75-year-old men and women. Scand J Med Sci Sports 1994; 4: 32-40.

    Google Scholar 

  16. Era P, Avlund K, Jokela J, et al. Postural balance and self-reported functional ability in 75-year-old men and women: A cross-national comparative study. J Am Geriatr Soc 1997; 45: 21-29.

    Google Scholar 

  17. Schultz-Larsen K, Avlund K, Kreiner S. Functional ability of community dwelling elderly. Criterion-related validity of a new measure of functional ability. J Clin Epidemiol 1992; 45: 1315-1327.

    Google Scholar 

  18. Avlund K, Thudium D, Davidsen M, Fuglsang-Sørensen B. Are self-ratings of functional ability reliable? Scand J Occup Ther 1995; 2: 10-16.

    Google Scholar 

  19. Holstein BE, Due EP, Almind G, Holst E. Which old age pensioners receive home help? A public health survey of 1,261 persons aged 70-95 years. (In Danish). Ugeskr Laeger 1990; 152: 228-232.

    Google Scholar 

  20. Holstein BE, Due P, Almind G, Holst E. The home-help service in Denmark. In: Jamieson A (ed), Home are for older people in Europe. A comparison of policies and practices. Oxford: Oxford Medical Publications, 1991.

    Google Scholar 

  21. Lammi UK, Kivelä SK, Nissinen A, Pekkanen J, Punsar S. Functional capacity and associated factors in elderly Finnish men. Scand J Soc Med 1989; 17: 67-75.

    Google Scholar 

  22. Bowling A, Windsor J. Discriminatory power of the health status questionnaire 12 in relation to age, sex, and longstanding illness: Findings from a survey in Great Britain. J Epidemiol Community Health 1997; 51: 564-573.

    Google Scholar 

  23. Fillenbaum GG. Screening the elderly. A brief instrumental activities of daily living measure. J Am Geriatr Soc 1985; 33: 698-706.

    Google Scholar 

  24. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990; 38: 855-861.

    Google Scholar 

  25. Fortinsky RH, Granger CV, Seltzer GB. The use of functional assessment in understanding home care needs. Med Care 1981; 19: 489-497.

    Google Scholar 

  26. Spector WD, Katz S, Murphy JB, Fulton JP. The Hi-erarchical relationship between activities of daily living and instrumental activities of daily living. J Chronic Dis 1987; 40: 481-489.

    Google Scholar 

  27. Kempen GIJM, Suurmeijer TPBM. The development of a hierarchical polychotomous ADL-IADL scale for noninstitutionalized elders. Gerontologist 1990; 30: 497-502.

    Google Scholar 

  28. Suurmeijer TPBM, Doeglas DM, Moum T. The Gro-ningen Activity Restriction Scale for measuring disabiltiy: Its utility in international comparisons. Am J Public Health 1994; 84: 1270-1273.

    Google Scholar 

  29. Åsberg KH, Sonn U. The cumulative structure of Personal and Instrumental ADL. A study of elderly people in a health service district. Scand J Rehabil Med 1988; 21: 171-177.

    Google Scholar 

  30. Avlund K, Schultz-Larsen K, Kreiner S. The measurement of Instrumental ADL: Content validity and construct validity. Aging Clin Exp Res 1993; 5: 371-383.

    Google Scholar 

  31. Deeg DJH. Sex differences in IADL in the Netherlands: Functional and situational disability. In: Robine J-M, Mathers CD, Bone MR, Romieu I (eds), Calculation of health expectancies: Harmonization, consensus achieved and future perspectives. INSERM/John Libey Eurotext Ltd, 1993: 203-213.

  32. Myers AM. The Clinical Swiss Army Knife. Empirical evidence on the validity of IADL functional status measures. Med Care 1992; 30: MS96-MS111.

    Google Scholar 

  33. Allen SM, Mor V, Ravies V, Houts P. Measurement of need for assistance with daily activities: Quantifying the influence of gender roles. J Gerontol 1993; 48: S204-S211.

    Google Scholar 

  34. Jamieson A, ed. Home care for older people in Europe. A comparison of policies and practices. Oxford: Oxford Medical Publications, 1991.

  35. Thorslund M, Wä rneryd B. Surveying the elderly about health, medical care and living conditions. Some issues of response inconsistency. Arch Gerontol Geriatr 1990; 11: 161-173.

    Google Scholar 

  36. Jette AM, Deniston OL. Inter-observer reliability of a functional status assessment instrument. J Chronic Dis 1978; 31: 573-580.

    Google Scholar 

  37. Rubenstein LZ, Schairer C, Wieland GD, Kane R. Systematic biases in functional status assessment of elderly adults: Effects of different data sources. J Ger-ontol 1984; 39: 686-691.

    Google Scholar 

  38. Green CR, Mohs RC, Schmeidler J, Aryan M, Davis KL. Functional decline in Alzheimer's disease: A lon-gitudinal study. J Am Geriatr Soc 1993; 41: 654-661.

    Google Scholar 

  39. Keller DM, Kovar MG, Jobe JB, Branch LG. Problems eliciting elders' reports of functional status. J Aging Health 1993; 5: 306-318.

    Google Scholar 

  40. Guralnik JM, LaCroix AZ, Abbott RD. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol 1993; 137: 845-857.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Avlund, K., Holstein, B.E. Functional ability among elderly people in three service settings: The discriminatory power of a new functional ability scale. Eur J Epidemiol 14, 783–790 (1998). https://doi.org/10.1023/A:1007508724943

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007508724943

Navigation