Dataset Information

Why Do Older Korean Adults Respond Differently to Activities of Daily Living and Instrumental Activities of Daily Living? A Differential Item Functioning Analysis.

ABSTRACT:

Objectives

Culture-based gender norms regarding who performs daily activities can bias the assessment of instrumental activities of daily living (IADL). This study evaluated item-response biases in the activities of daily living (ADL) and IADL among community-living Korean older adults.

Methods

The subjects included older Korean participants of the Korean Longitudinal Study of Ageing baseline survey (n=4,164). We performed differential item functioning (DIF) analysis of these data using the Mantel-Haenszel method.

Results

We observed different reported levels of disability for eight IADL items among gender, age, and educational level subgroups. After matching for overall functional disability, men were more likely to report limitations in performing various household activities, compared to cognitive activities in women.

Conclusions

Cross-national comparisons of ADL and IADL disabilities need to consider item response bias stemming from culture-based gender norms regarding who performs different household activities.

SUBMITTER: Jang SN

PROVIDER: S-EPMC7370754 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

Why Do Older Korean Adults Respond Differently to Activities of Daily Living and Instrumental Activities of Daily Living? A Differential Item Functioning Analysis.

Jang Soong-Nang SN Kawachi Ichiro I

Annals of geriatric medicine and research 20191230 4

<h4>Objectives</h4>Culture-based gender norms regarding who performs daily activities can bias the assessment of instrumental activities of daily living (IADL). This study evaluated item-response biases in the activities of daily living (ADL) and IADL among community-living Korean older adults.<h4>Methods</h4>The subjects included older Korean participants of the Korean Longitudinal Study of Ageing baseline survey (n=4,164). We performed differential item functioning (DIF) analysis of these data ...[more]

PMID: 32743312

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Project description:RationalePoor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome.ObjectivesTo conduct a systematic review of studies evaluating IADLs in survivors of critical illness.MethodsWe searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016. Additional articles were identified from personal files and reference lists of eligible studies. Two trained researchers independently reviewed titles and abstracts, and potentially eligible full text studies. Eligible studies included those enrolling adult ICU survivors with IADL assessments, using a validated instrument. We excluded studies involving specific ICU patient populations, specialty ICUs, those enrolling fewer than 10 patients, and those that were not peer-reviewed. Variables related to IADLs were reported using the Patient Reported Outcomes Measurement Information System (PROMIS).ResultsThirty of 991 articles from our literature search met inclusion criteria, and 23 additional articles were identified from review of reference lists and personal files. Sixteen studies (30%) published between 1999 and 2016 met eligibility criteria and were included in the review. Study definitions of impairment in IADLs were highly variable, as were reported rates of pre-ICU IADL dependencies (7-85% of patients). Eleven studies (69%) found that survivors of critical illness had new or worsening IADL dependencies. In three of four longitudinal studies, survivors with IADL dependencies decreased over the follow-up period. Across multiple studies, no risk factors were consistently associated with IADL dependency.ConclusionsSurvivors of critical illness commonly experience new or worsening IADL dependency that may improve over time. As part of ongoing efforts to understand and improve functional status in ICU survivors, future research must focus on risk factors for IADL dependencies and interventions to improve these cognitive and physical dependencies after critical illness.

Project description:BackgroundFinding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors.MethodsWe performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer's Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model.ResultsWe included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern.ConclusionOur results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.

Dataset Information

Why Do Older Korean Adults Respond Differently to Activities of Daily Living and Instrumental Activities of Daily Living? A Differential Item Functioning Analysis.

Objectives

Methods

Results

Conclusions

Publications

Why Do Older Korean Adults Respond Differently to Activities of Daily Living and Instrumental Activities of Daily Living? A Differential Item Functioning Analysis.

Similar Datasets

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