Measuring the activities of daily living: comparisons across national surveys.

The "activities of daily living," or ADLs, are the basic tasks of everyday life, such as eating, bathing, dressing, toileting, and transferring. Reported estimates of the size of the elderly population with ADL disabilities differ substantially across national surveys. Differences in which ADL items are being measured and in what constitutes a disability account for much of the variation. Other likely explanations are differences in sample design, sample size, survey methodology, and age structure of the population to which the sample refers. When essentially equivalent ADL measures are compared, estimates for the community-based population vary by up to 3.1 percentage points; and for the institutionalized population, with the exception of toileting, by no more than 3.2 percentage points. As small as these differences are in absolute terms, they can be large in percent differences across surveys. For example, the National Medical Expenditure Survey estimates that there are 60 percent more elderly people with ADL problems than does the Supplement on Aging.

[1]  S. Katz Studies of illness in the aged , 1963 .

[2]  M. Lawton,et al.  Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living , 1969 .

[3]  S. Katz,et al.  A Measure of Primary Sociobiological Functions , 1976, International journal of health services : planning, administration, evaluation.

[4]  B S Linn,et al.  Self‐Assessed Health, Impairment and Disability in Anglo, Black and Cuban Elderly , 1980, Medical care.

[5]  A. B. Ford Assessing the Elderly: A Practical Guide to Measurement , 1982 .

[6]  A M Jette,et al.  A prospective study of long-term care institutionalization among the aged. , 1982, American journal of public health.

[7]  Sydney Katz Assessing Self‐maintenance: Activities of Daily Living, Mobility, and Instrumental Activities of Daily Living , 1983, Journal of the American Geriatrics Society.

[8]  G. Fillenbaum,et al.  The wellbeing of the elderly. Approaches to multidimensional assessment. , 1984, WHO offset publication.

[9]  Kenneth G. Manton,et al.  Home care expenses for the disabled elderly , 1985, Health care financing review.

[10]  K. Manton,et al.  Health status and service needs of the oldest old: current patterns and future trends. , 1985, The Milbank Memorial Fund quarterly. Health and society.

[11]  A R Feinstein,et al.  Scientific and clinical problems in indexes of functional disability. , 1986, Annals of internal medicine.

[12]  Disability, Functional Limitation, and Health Insurance Coverage: 1984/85. Data from the Survey of Income and Program Participation. , 1986 .

[13]  C. Bishop Living arrangement choices of elderly singles: Effects of income and disability , 1986, Health care financing review.

[14]  C. Macken A profile of functionally impaired elderly persons living in the community , 1986, Health care financing review.

[15]  A. Garber,et al.  Long-Term Care, Wealth, and Health of the Disabled Elderly Living in the Community , 1987 .

[16]  W. Spector,et al.  The hierarchical relationship between activities of daily living and instrumental activities of daily living. , 1987, Journal of chronic diseases.

[17]  L. Branch,et al.  Assessing physical function in the elderly. , 1987, Clinics in geriatric medicine.

[18]  W O Spitzer,et al.  State of science 1986: quality of life and functional status as target variables for research. , 1987, Journal of chronic diseases.

[19]  K G Manton,et al.  A longitudinal study of functional change and mortality in the United States. , 1988, Journal of gerontology.

[20]  The influence of source of insurance coverage on the health care utilization patterns of the elderly. , 1989, Journal of health and human resources administration.

[21]  L G Branch,et al.  Physical performance measures in aging research. , 1989, Journal of gerontology.

[22]  Toni R. Hanna Caring for the Disabled Elderly: Who Will Pay? , 1990 .