School of Rehabilitation Science, Ontario, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
J Gerontol A Biol Sci Med Sci. 2019 Mar 14;74(4):556-559. doi: 10.1093/gerona/gly230.
The Late-Life Function and Disability Instrument (LLFDI) is a well-validated and frequently used patient-reported outcome for older adults. The aim of this study was to estimate the minimal clinically important difference (MCID) of the LLFDI-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations.
We performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly, a longitudinal cohort study of older adults with mobility limitations residing in the community. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated using both anchor- and distribution-based methods, including mean change scores on a patient-reported global rating of change in function scale, the standard error of measurement (SEM), and the minimal detectable change with 90% confidence (MDC90).
Data from 320 older adults were used in the analysis (mean age 76 years, 69% female, mean of four chronic conditions). Meaningful change estimates for "small change" based on the global rating of change and SEM were 2, 3, 4, and 4 points for the LLFDI-FC overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Estimates for "substantial change" based on the global rating of change and minimal detectable change with 90% confidence were 5, 6, 9, and 10 points for the overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively.
This study provides the first MCID estimates for the LLFDI-FC, a widely used patient-reported measure of function. These values can be used to interpret the outcomes of longitudinal investigations of functional status in similar populations of community-dwelling older adults.
晚年功能和残疾量表（LLFDI）是一种经过充分验证且常用于老年患者的常用患者报告结局测量工具。本研究旨在为有移动障碍的社区居住老年患者估计 LLFDI-功能分量表（LLFDI-FC）及其分量表的最小临床重要差异（MCID）。
我们对波士顿老年康复障碍研究进行了二次分析，该研究是一项针对有移动障碍的社区居住老年患者的纵向队列研究。使用基于锚定和分布的方法，包括患者报告的功能总体变化的全球评分变化的平均变化分数、测量的标准误差（SEM）以及 90%置信度的最小可检测变化（MDC90），估计了 1 年随访期间每个 LLFDI-FC 量表的 MCID。
对 320 名老年患者的数据进行了分析（平均年龄 76 岁，69%为女性，平均患有四种慢性病）。基于全球变化评分和 SEM 的“小变化”有意义的变化估计值分别为 2、3、4 和 4 点，用于 LLFDI-FC 整体功能量表以及基本下肢、高级下肢和上肢分量表。基于全球变化评分和 90%置信度的最小可检测变化的“大变化”估计值分别为 5、6、9 和 10 点，用于 LLFDI-FC 整体功能量表以及基本下肢、高级下肢和上肢分量表。
本研究提供了 LLFDI-FC 的第一个 MCID 估计值，这是一种广泛使用的功能患者报告测量工具。这些值可用于解释具有类似社区居住老年患者的功能状态的纵向研究的结果。
