A Hierarchical Exercise Scale to Measure Function at the Advanced Activities of Daily Living (AADL) Level

Standard functional assessment instruments often fail to capture subtle impairment in community‐dwelling older persons. To create a scale to measure function at the Advanced Activities of Daily Living (AADL) level, we chose three questions to separate a community sample into four levels: frequent vigorous exercisers (8.0%), frequent long walkers (10.8%), frequent short walkers (23.7%), and nonexercisers (57.5%). These levels of exercise formed a hierarchical scale that correlated positively in a graduated manner with progressively advanced social activities of daily living, current health status, and mental health. At 1‐year follow‐up, 20% of persons declined in exercise level, 63% showed no change in exercise level, and 17% improved their exercise level. Changes in exercise level in both directions were associated with changes in mental health status. The Advanced Activities of Daily Living scale may be a sensitive measure of earlier functional decline, but longer follow‐up will be necessary to determine its clinical usefulness.

[1]  C. Mackenzie,et al.  A patient-specific measure of change in maximal function. , 1986, Archives of internal medicine.

[2]  M. Lawton,et al.  Assessment of older people: self-maintaining and instrumental activities of daily living. , 1969, The Gerontologist.

[3]  J. Murphy,et al.  Risk of functional decline among well elders. , 1989, Journal of clinical epidemiology.

[4]  D B Reuben,et al.  Assessment in Geriatrics , 1989, Journal of the American Geriatrics Society.

[5]  Peter Talty,et al.  Assessing the Elderly: A Practical Guide to Measurement , 1983 .

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

[7]  Gerda G. Fillenbaum,et al.  Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures , 1988 .

[8]  P E Leaverton,et al.  Predictors of good function: the Framingham Study. , 1987, Journal of chronic diseases.

[9]  S. Z. Nagi.  An epidemiology of disability among adults in the United States. , 1976, The Milbank Memorial Fund quarterly. Health and society.

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

[11]  A. Stewart,et al.  The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. , 1989, JAMA.

[12]  J. Halter,et al.  Correlates of Preventive Health Behavior in Late Life , 1987, Research on aging.

[13]  A M Jette,et al.  The Framingham Disability Study: I. Social disability among the aging. , 1981, American journal of public health.

[14]  L. Rubenstein,et al.  Predictors of Immediate and 6‐Month Outcomes in Hospitalized Elderly Patients , 1988, Journal of the American Geriatrics Society.

[15]  I. Rosow,et al.  A Guttman health scale for the aged. , 1966, Journal of gerontology.

[16]  S. Katz,et al.  Progress in development of the index of ADL. , 1970, The Gerontologist.

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

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