Fong Joelle H, Youn Yongjoon
Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore City, Singapore.
Gerontologist. 2023 May 9;63(4):773-782. doi: 10.1093/geront/gnac057.
This study examined the stability over time of activities of daily living (ADL) items in 3 comparable longitudinal data sets and evaluated ADL loss sequences for older adults in the United States, South Korea, and Japan.
Data from the U.S. Health and Retirement Study, and its 2 international sister surveys, were analyzed. Participants were community-dwelling adults aged 60 and older. For each data set, Rasch analysis was implemented to determine if the ordering of items remained stable across multiple waves (2006-2014), such that a single ADL hierarchy may be derived from multiwave data.
Data fitted the Rasch model well. Item calibrations were sufficiently stable across measurement periods in each data set, reflecting a stable frame of reference. Results were also robust to sample variations. The derived ADL hierarchies based on scaled logit scores revealed that "dressing" and "bathing" were relatively more difficult items for older adults in all study populations.
Scale stability is essential when exploiting longitudinal data to analyze patterns in ADL disabilities. The consistency in ADL scales across measurement periods supports their use as screening tools and identifying those at risk for transitions in care. Interventions to reduce dependency in bathing and dressing can help improve independent functioning for community-dwelling older adults.
本研究考察了3个可比纵向数据集中日常生活活动（ADL）项目随时间的稳定性，并评估了美国、韩国和日本老年人的ADL丧失序列。
分析了来自美国健康与退休研究及其两项国际姊妹调查的数据。参与者为60岁及以上的社区居住成年人。对于每个数据集，实施拉施分析以确定项目的排序在多个时间段（2006 - 2014年）内是否保持稳定，以便可以从多时间段数据中得出单一的ADL层次结构。
数据很好地拟合了拉施模型。每个数据集中项目校准在测量期间足够稳定，反映了一个稳定的参照框架。结果对样本差异也具有稳健性。基于缩放对数几率得分得出的ADL层次结构表明，在所有研究人群中，“穿衣”和“洗澡”对老年人来说相对更困难。
在利用纵向数据分析ADL残疾模式时，量表稳定性至关重要。ADL量表在测量期间的一致性支持将其用作筛查工具以及识别有护理转变风险的人群。减少洗澡和穿衣依赖的干预措施有助于改善社区居住老年人的独立功能。
