Department of Nutrition, Metabolism & Rehabilitation Sciences, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA.
Department of Interior Design, Iowa State University, Ames, IA 50011, USA.
Int J Environ Res Public Health. 2022 Apr 13;19(8):4691. doi: 10.3390/ijerph19084691.
Identifying individuals at risk of experiencing functional difficulty at home would support timely home safety assessment and modification services, which could lead to reducing home incidents such as falls. The objective of this study was to calculate older adults’ functional difficulty at home scores using the 12 physical function items in the American Housing Survey National and Metropolitan Data (AHS). Among the 28,474 older adults selected for this study, we used 19,932 for measurement model development and 8542 for model testing. Confirmatory factor analysis confirmed an adequate fit of the one-dimensional model with all AHS 12 items loading on one latent construct (functional difficulty at home) (RMSEA: 0.034, CFI: 0.990, and TLI: 0.988). Based on our model selection process, we determined that the Graded Response Model was an optimal model for our analysis and separated two detected differential functioning items for each sex. Using the testing dataset, we validated that the estimated functional difficulty scores showed an expected item hierarchy and statistically significant differences in their association with housing and demographic conditions (p < 0.001). Our results demonstrated the process of using the 12 AHS physical function at home items to produce validated scores of older adults’ functional difficulty at home.
识别有居家功能困难风险的个体将有助于及时进行居家安全评估和改造服务，从而减少居家事故的发生，如跌倒。本研究的目的是使用美国家庭调查全国和大都市数据（AHS）中的 12 项身体功能项目来计算老年人的居家功能困难得分。在为本研究选择的 28474 名老年人中，我们使用了 19932 名进行测量模型开发，使用 8542 名进行模型测试。验证性因子分析证实了一个维度模型的良好拟合，所有 AHS 12 项都加载在一个潜在结构（居家功能困难）上（RMSEA：0.034，CFI：0.990，TLI：0.988）。根据我们的模型选择过程，我们确定分级反应模型是我们分析的最佳模型，并为每个性别分离了两个检测到的差异功能项目。使用测试数据集，我们验证了估计的功能困难得分显示出预期的项目层次结构，并且与住房和人口统计学条件的关联具有统计学意义（p<0.001）。我们的研究结果展示了使用 AHS 中的 12 项身体功能项目来生成老年人居家功能困难的验证得分的过程。
