The assessment of disability with the Groningen Activity Restriction Scale. Conceptual framework and psychometric properties.

The conceptual framework, psychometric properties, descriptive statistics, and the rules for administration and scoring of the Groningen Activity Restriction Scale (GARS) for assessing disability in the area of ADL (Activities of Daily Living including mobility) as well as IADL (Instrumental Activities of Daily Living) are presented. The result show that the GARS, which can be administered both face-to-face and by mail questionnaire, is an easy to administer, comprehensive, reliable, hierarchical, and valid measure for assessing disability in older people. By integrating previously developed scales measuring different domains of disability (ADL, IADL, and mobility) and the use of a four-category response format, an accurate and detailed measure of disability can be obtained and a broader range of needs of subjects can be described. The GARS manual, including detailed procedures for administration and scoring, encourages unambiguous administration and interpretation which results in more comparable research outcomes.

[1]  D. Barer,et al.  Measurement of activities of daily living , 1989 .

[2]  R. Hays,et al.  Hierarchical Measures of Physical Function in Ambulatory Geriatrics , 1990, Journal of the American Geriatrics Society.

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

[4]  G I Kempen,et al.  Hierarchical structure in ADL and IADL: analytical assumptions and applications for clinicians and researchers. , 1995, Journal of clinical epidemiology.

[5]  M Thorslund,et al.  Physical function and social class among Swedish oldest old. , 1994, Journal of gerontology.

[6]  G. Fillenbaum,et al.  Screening the Elderly , 1985, Journal of the American Geriatrics Society.

[7]  Charles Lewis,et al.  A Nonparametric Approach to the Analysis of Dichotomous Item Responses , 1982 .

[8]  R. J. Johnson,et al.  The structure of health status among older adults: disease, disability, functional limitation, and perceived health. , 1993, Journal of health and social behavior.

[9]  D. Patrick,et al.  Use of multivariate measures of disability in health surveys. , 1983, Journal of epidemiology and community health.

[10]  T. Suurmeijer,et al.  Factors influencing professional home care utilization among the elderly. , 1991, Social science & medicine.

[11]  B Kirshner,et al.  A methodological framework for assessing health indices. , 1985, Journal of chronic diseases.

[12]  A. E. Bennett,et al.  A validated interview schedule for use in population surveys of chronic disease and disability. , 1971, British journal of preventive & social medicine.

[13]  G. Fillenbaum,et al.  The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. , 1981, Journal of gerontology.

[14]  J. Wiener,et al.  Measuring the activities of daily living: comparisons across national surveys. , 1990, Journal of gerontology.

[15]  I. W. Molenaar,et al.  An application of Mokken's model for stochastic, cumulative scaling in psychiatric research. , 1987, Journal of psychiatric research.

[16]  K. Sijtsma,et al.  MSP: A program for Mokken Scale analysis for Polytomous Items: Version 3.0: User's manual , 1994 .

[17]  M. Law,et al.  A critical review of scales of activities of daily living. , 1989, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[18]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[19]  A. Stewart,et al.  The MOS short-form general health survey. Reliability and validity in a patient population. , 1988, Medical care.

[20]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

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

[22]  Andrew M. Pope,et al.  Disability in America: Toward a National Agenda for Prevention. Summary and Recommendations. , 1991 .

[23]  T. Suurmeijer,et al.  The development of a hierarchical polychotomous ADL-IADL scale for noninstitutionalized elders. , 1990, The Gerontologist.

[24]  S. Kreiner,et al.  Construct validation and the Rasch model , 1993, Scandinavian journal of social medicine.

[25]  F. Sturmans,et al.  A scale for the functional status of the elderly living at home. , 1991, Journal of advanced nursing.

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

[27]  S. Kreiner,et al.  The measurement of Instrumental ADL: Content validity and construct validity , 1993, Aging.

[28]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[29]  Ian R. Cameron,et al.  Multidimensional Functional Assessment: The OARS Methodology. A Manual , 1978 .

[30]  A. Myers The clinical Swiss army knife. Empirical evidence on the validity of IADL functional status measures. , 1992, Medical care.

[31]  F Guillemin,et al.  The Groningen Activity Restriction Scale for measuring disability: its utility in international comparisons. , 1994, American journal of public health.

[32]  J. Morris,et al.  An assessment tool for use in identifying functionally vulnerable persons in the community. , 1984, The Gerontologist.

[33]  B. Ford International Classification of Impairments, Disabilities and Handicaps , 1984, Releve epidemiologique hebdomadaire.

[34]  P. Eakin Assessments of Activities of Daily Living: A Critical Review , 1989 .

[35]  T. Suurmeijer,et al.  Professional home care for the elderly: an application of the Andersen-Newman model in The Netherlands. , 1991, Social science & medicine.

[36]  C. Franceschi,et al.  Free radicals: Only part of the story? , 1993, Aging.

[37]  Robert J. Mokken,et al.  A Theory and Procedure of Scale Analysis. , 1973 .

[38]  E. Berkowitz Disability policies and government programs , 1979 .

[39]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .