Giving meaning to the scores of the Amsterdam instrumental activities of daily living questionnaire: a qualitative study.
Alzheimer’s disease
Bookmarking
Clinical meaningfulness
Dementia
Functional impairment
Thresholds
Journal
Health and quality of life outcomes
ISSN: 1477-7525
Titre abrégé: Health Qual Life Outcomes
Pays: England
ID NLM: 101153626
Informations de publication
Date de publication:
24 Mar 2022
24 Mar 2022
Historique:
received:
22
11
2021
accepted:
15
03
2022
entrez:
25
3
2022
pubmed:
26
3
2022
medline:
29
3
2022
Statut:
epublish
Résumé
Everyday functioning is a clinically relevant concept in dementia, yet little is known about the clinical meaningfulness of scores on functional outcome measures. We aimed to establish clinically meaningful scoring categories for the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q), representing no, mild, moderate and severe problems in daily functioning. Informal caregivers (n = 6) of memory-clinic patients and clinicians (n = 13), including neurologists and nurse specialists, working at various memory clinics in The Netherlands. In focus groups, participants individually ranked nine summaries of fictional patients from least to most impairment in daily functioning. Then, they placed bookmarks to demarcate the thresholds for mild, moderate and severe problems. Individual bookmark placements were then discussed to reach consensus. Clinicians completed a survey in which they placed bookmarks, individually. While individual categorizations varied somewhat, caregivers and clinicians generally agreed on the thresholds, particularly about the distinction between 'no' and 'mild' problems. Score categories were no problems (T-score ≥ 60), mild problems (T-score 50-59), moderate problems (T-score 40-49), and severe problems in daily functioning (T-score < 40), on a scale ranging 20-80. Our findings provide categories for determining the level of functional impairment, which can facilitate interpretation of A-IADL-Q scores. These categories can subsequently be used by clinicians to improve communication with patients and caregivers.
Sections du résumé
BACKGROUND
BACKGROUND
Everyday functioning is a clinically relevant concept in dementia, yet little is known about the clinical meaningfulness of scores on functional outcome measures. We aimed to establish clinically meaningful scoring categories for the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q), representing no, mild, moderate and severe problems in daily functioning.
METHODS
METHODS
Informal caregivers (n = 6) of memory-clinic patients and clinicians (n = 13), including neurologists and nurse specialists, working at various memory clinics in The Netherlands. In focus groups, participants individually ranked nine summaries of fictional patients from least to most impairment in daily functioning. Then, they placed bookmarks to demarcate the thresholds for mild, moderate and severe problems. Individual bookmark placements were then discussed to reach consensus. Clinicians completed a survey in which they placed bookmarks, individually.
RESULTS
RESULTS
While individual categorizations varied somewhat, caregivers and clinicians generally agreed on the thresholds, particularly about the distinction between 'no' and 'mild' problems. Score categories were no problems (T-score ≥ 60), mild problems (T-score 50-59), moderate problems (T-score 40-49), and severe problems in daily functioning (T-score < 40), on a scale ranging 20-80.
CONCLUSIONS
CONCLUSIONS
Our findings provide categories for determining the level of functional impairment, which can facilitate interpretation of A-IADL-Q scores. These categories can subsequently be used by clinicians to improve communication with patients and caregivers.
Identifiants
pubmed: 35331258
doi: 10.1186/s12955-022-01958-2
pii: 10.1186/s12955-022-01958-2
pmc: PMC8943938
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
47Informations de copyright
© 2022. The Author(s).
Références
Alzheimers Dement (Amst). 2017 Mar 31;8:26-35
pubmed: 28462387
Int J Geriatr Psychiatry. 2019 Aug;34(8):1251-1261
pubmed: 31034650
Gerontologist. 1969 Autumn;9(3):179-86
pubmed: 5349366
Qual Life Res. 2014 Dec;23(10):2651-61
pubmed: 24938431
Alzheimers Res Ther. 2020 Oct 29;12(1):138
pubmed: 33121534
Int Psychogeriatr. 2014 Aug;26(8):1283-93
pubmed: 24784234
BMJ. 1995 Aug 5;311(7001):376-80
pubmed: 7640549
Neurodegener Dis Manag. 2014;4(5):393-400
pubmed: 25405652
Neuroepidemiology. 2013;41(1):35-41
pubmed: 23712106
J Am Geriatr Soc. 1999 Feb;47(2):196-202
pubmed: 9988291
Lancet. 2016 Jul 30;388(10043):505-17
pubmed: 26921134
Qual Life Res. 2017 Mar;26(3):565-586
pubmed: 27913986
J Prev Alzheimers Dis. 2017;4(2):81-86
pubmed: 29124043
Med Care. 2019 May;57 Suppl 5 Suppl 1:S13-S17
pubmed: 30985591
Alzheimers Dement (N Y). 2020 Dec 16;6(1):e12113
pubmed: 33344753
Alzheimers Dement (Amst). 2019 Jul 29;11:520-528
pubmed: 31388556
Alzheimers Dement. 2020 May;16(5):814
pubmed: 32386282
J Am Geriatr Soc. 2008 Jan;56(1):37-44
pubmed: 18028344
Acta Psychiatr Scand. 2014 Jan;129(1):63-72
pubmed: 23521526
Alzheimers Dement (Amst). 2016 Mar 10;2:105-12
pubmed: 27239541
Alzheimers Dement. 2012 Nov;8(6):536-43
pubmed: 23102123