Review
The Measurement of Disability in the Elderly: A Systematic Review of Self-Reported Questionnaires

https://doi.org/10.1016/j.jamda.2013.10.004Get rights and content

Abstract

Objective

To analyze the contents and formats of general self-reported questionnaires on disability that are designed for and/or are widely applied in the elderly population to depict a complete picture of this field and help researchers to choose proper tools more efficiently.

Methods

A broad systematic literature search was performed in September 2013 and included the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and PROQOLID. The publication language was limited to English and Chinese. Two review authors independently performed the study selection and data extraction. All of the included instruments were extracted and classified using the International Classification of Functioning, Disability, and Health framework.

Results

Of 5569 articles retrieved from the searches and 156 articles retrieved from the pearling, 22 studies (including 24 questionnaires) fulfilled the inclusion criteria. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the Barthel Index followed by the Lawton and Brody Instrumental Activities of Daily Living Scale and the Katz Index of Activities of Daily Living, respectively. The contents and formats of the questionnaires varied considerably. Activities and participation were the most commonly assessed dimensions. In addition, the Activities of Daily Living, mobility and the Instrumental Activities of Daily Living Scale were the most common domains assessed among the included questionnaires.

Conclusions

Among the 24 included questionnaires, the most frequently used questionnaires were the Barthel Index, Lawton and Brody Instrumental Activities of Daily Living Scale, and Katz Index of Activities of Daily Living. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all essential dimensions of the International Classification of Functioning, Disability, and Health framework.

Section snippets

Methods

Unlike other literature reviews, a systematic review is defined as a review that systematically searches for, appraises, and synthesizes research evidence, often adhering to guidelines on the conduct of a review.16 In this review, we followed standard systematic review methodology as listed in the handbook of the Center for Reviews and Dissemination17 and reported our findings following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines for reporting

Literature Search

The electronic search identified a total of 7990 hits. Among them, 3891 papers were found in MEDLINE, 3367 in EMBASE, 293 in CINAHL, and 439 in PsycINFO. After removing duplicates, a total of 5569 papers were available for screening (Figure 1).

Study Selection

The study selection procedure is described in Figure 1. After screening the titles and abstracts, 141 potentially eligible studies were identified. There was an initial agreement of 87% on the included studies (n = 122). After discussion, full agreement

Discussion

This systematic review identified a large number of questionnaires for measuring disability in the elderly. Approximately one-half of the included questionnaires were specifically designed for the elderly; the others were not developed for the elderly but were widely applied in the elderly population. The BI, LB-IADL, and KI were the most popular tools in the field. The content and format of the questionnaires varied considerably. ADL, mobility and IADL were the most common domains assessed

Conclusions

This review identified 24 self-reported disability questionnaires that were developed for or widely used in the elderly. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the BI followed by the LB-IADL and KI. ADL, mobility, and IADL were the most common outcomes applied in this field. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all of the essential dimensions of the ICF.

Acknowledgments

This study is part of the research project named Geriatric Comprehensive Assessment and Health Care Service System in Chinese Elderly, which was funded by National Department Public Benefit Research Foundation by Ministry of Health P. R. China (No. 201002011). The sponsor has no role in the design, methods, data collection, analysis and preparation of paper.

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    M.Y. and X.D. contributed equally to this work.

    The authors declare no conflict of interest.

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