Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-28T09:58:30.320Z Has data issue: false hasContentIssue false

The Erlangen Test of Activities of Daily Living: first results on reliability and validity of a short performance test to measure fundamental activities of daily living in dementia patients

Published online by Cambridge University Press:  17 October 2008

Elmar Graessel*
Affiliation:
Department of Medical Psychology and Medical Sociology, Psychiatric University Clinic Erlangen, Germany
Reena Viegas
Affiliation:
Clinic Grabs, Grabs, Switzerland
Renate Stemmer
Affiliation:
Catholic University of Applied Sciences Mainz, Germany
Brita Küchly
Affiliation:
Social Centre “Sophienstrasse” Erlangen, Germany
Johannes Kornhuber
Affiliation:
Psychiatric University Clinic Erlangen, Germany
Carolin Donath
Affiliation:
Department of Medical Psychology and Medical Sociology, Psychiatric University Clinic Erlangen, Germany
*
Correspondence should be addressed to: Prof. Dr. Elmar Graessel, Psychiatrische Universitätsklinik Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany. Phone: +49 9131 85 34810; Fax: +49 9131 85 36593. Email: [email protected].

Abstract

Background: In the absence of an easily applicable performance test for making valid measurements of fundamental activities of daily living (ADL) in dementia patients, this study reports the development of an ADL performance test which constitutes both a reliable and a valid measurement of the relevant autonomous areas of everyday activities for dementia patients.

Methods: The Erlangen Test of Activities of Daily Living (E-ADL-Test) consists of five items: pouring a drink, cutting a piece of bread, opening a small cupboard, washing hands and tying a bow. Each test item underwent standardized evaluation on a scale of 0 to 6. To determine retest reliability each assessment was repeated at two-weekly intervals. The Global Deterioration Scale, Mini-mental State Examination (MMSE) and Nurses' Observations Scale for Geriatric Patients (NOSGER) were used to assess construct validity. Spearman's rank correlation coefficient was applied. Forty-six patients (42 women and 4 men) with clinically diagnosed dementia, who were resident in nursing homes, took part in the validation study. Their average age was 86.

Results: The E-ADL-Test revealed good inter-individual differentiation ability, particularly in cases of moderate to severe dementia. Cronbach's α was 0.77, retest reliability 0.73. The correlation coefficients were −0.47 with GDS, 0.60 with NOSGER and 0.72 with MMSE.

Conclusions: The E-ADL-Test is a suitable performance test for measuring activities of daily living as it is easy to use, reliable, valid and well accepted.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, DSM-IVTR (4th edition, text revision). Washington DC: American Psychiatric Association.Google Scholar
Borst, J. (2003). Statistik für Sozialwissenschaftler [Statistics for Social Scientists], Berlin v.a.: Springer.Google Scholar
Carnero-Pardo, C. et al. (2006). Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study. BMC Neurology, 6, 15.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Hampel, H., Padberg, F. and Möller, H.-J. (2003). Alzheimer-Demenz [Alzheimer's Disease], Stuttgart: Wissenschaftliche Verlagsgesellschaft.Google Scholar
Hindmarch, I., Lehfeld, H., Jongh, P. and Erzigkeit, H. (1998). The Bayer Activities of Daily Living Scale (B-ADL). Dementia and Geriatric Cognitive Disorders, 9 (Suppl. 2), 2026.CrossRefGoogle ScholarPubMed
Ihl, R. and Fröhlich, L. (1991). Die Reisberg-Skalen GDS, CRS, FAST [The Reisberg Scales GDS, CRS, FAST], Weinheim: Beltz Test.Google Scholar
IVAR (Internationale Vereinigung für Assessment in der Rehabilitation) [International Society for Assessment in Rehabilitation] (1999). Manual FIM – Funktionale Selbständigkeitsmessung [FIM – Functional Independent Measure], Straubing: IVAR.Google Scholar
Ivemeyer, D. and Zerfaß, R. (2006). Demenztests in der Praxis – ein Wegweiser [Dementia Tests in Practice − A Guide], München, Jena: Urban and Fischer.Google Scholar
Karagiozis, H., Gray, S., Sacco, J., Shapiro, M. and Kawas, C. (1998). The Direct Assessment of Functional Abilities (DAFA): a comparison to an indirect measure of Instrumental Activities of Daily Living. The Gerontologist, 38, 113121.CrossRefGoogle Scholar
Kessler, J., Markowitsch, H. J. and Denzler, P. (1990). Mini-Mental-Status-Test. Weinheim: Beltz Test.Google Scholar
Khin-Heung Chong, D. (1995). Measurement of instrumental activities of daily living in stroke. Stroke, 26, 11191122.CrossRefGoogle ScholarPubMed
Kuriansky, J. and Gurland, B. (1976). Self care capacity: the performance tests of activities of daily living. International Journal of Aging and Human Development, 7, 343352.CrossRefGoogle Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179186.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 6165.Google ScholarPubMed
Oremus, M., Perrault, A., Demers, L. and Wolfson, C. (2000). Review of outcome measurement instruments in Alzheimer's disease drug trials: psychometric properties of global scales. Journal of Geriatric Psychiatry and Neurology, 13, 197205.CrossRefGoogle ScholarPubMed
Podsiadlo, D. and Richardson, S. (1991). The timed “Up and Go”: a test of functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142148.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S. H., Leon, M. J. de and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 11361139.Google ScholarPubMed
Schmand, B., Lindenboom, J., Hooijer, C. and Jonker, C. (1995). Relation between education and dementia: the role of test bias revisited. Journal of Neurology, Neurosurgery, and Psychiatry, 59, 170174.CrossRefGoogle ScholarPubMed
Sidani, S. (2003) Self-care. In Dorane, D. (ed.) Nursing-sensitive Outcomes (pp. 65113). Boston: Jones and Bartlett.Google Scholar
Skurla, E., Rogers, J. C. and Sunderland, T. (1988). Direct assessment of activities of daily living in Alzheimer's disease: a controlled study. Journal of the American Geriatrics Society, 36, 97103.CrossRefGoogle ScholarPubMed
Spector, W. D., Katz, S., Murphy, J. B. and Fulton, J. P. (1987). The hierarchical relationship between activities of daily living and instrumental activities of daily living. Journal of Chronic Diseases, 40, 481489.CrossRefGoogle ScholarPubMed
Spiegel, R. (1992). Erfassung des Verhaltens psychogeriatrischer Patienten im Alltag mit der NOSGER [Recording the behaviour of psycho-geriatric patients in daily life using NOSGER]. In Jovic, N. I. and Uchtenhagen, A. (eds.), Ambulante Psychogeriatrie: neue Wege und Hinweise für die Praxis [Outpatient Psychogeriatrics: New Ways and Tips]. Kröning: Roland Asanger Verlag.Google Scholar
Spiegel, R. et al. (1991). A new behavioral assessment scale for geriatric out- and inpatients: the NOSGER (Nurses' Observation Scale for Geriatric Patients). Journal of the American Geriatrics Society, 39, 339347.CrossRefGoogle ScholarPubMed
Wahle, M., Häller, S. and Spiegel, R. (1996). Validation of the NOSGER: reliability and validity of a caregiver rating instrument. International Psychogeriatrics, 8, 525547.CrossRefGoogle ScholarPubMed
World Health Organization (1999). International Classification of Diseases (ICD-10). Chapter V: Mental and Behavioral Disorders (Trans. Dilling, H., Mombour, W. and Schmidt, M. H.) Bern: Huber.Google Scholar
Supplementary material: File

Graessel Supplementary Material

Appendix1.doc

Download Graessel Supplementary Material(File)
File 55.3 KB
Supplementary material: File

Graessel Supplementary Material

Appendix2.doc

Download Graessel Supplementary Material(File)
File 60.4 KB