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The Gerontologist Advance Access first published online on June 8, 2009
This version published online on July 9, 2009
The Gerontologist, doi:10.1093/geront/gnp064
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

Lifestyle-Adjusted Function: Variation Beyond BADL and IADL Competencies

Steven M. Albert, PhD, MSPH1,2, Jane Bear-Lehman, PhD3 and Ann Burkhardt, OTD, OTR/L, FAOTA4

2 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
3 Department of Occupational Therapy, New York University
4 Department of Occupational Therapy, Quinnipiac University, Hamden, Connecticut

1 Address correspondence to Steven M. Albert, PhD, Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, A211 Crabtree Hall, 120 DeSoto Avenue, Pittsburgh, PA 15261.E-mail: smalbert{at}pitt.edu


  Abstract

Purpose: Using the Activity Card Sort (ACS), we derived a measure of lifestyle-adjusted function and examined the distribution of this measure and its correlates in a community sample of older adults at risk for disability transitions. Design and Methods: Participants in the Sources of Independence in the Elderly project (n = 375) completed the ACS using a Q-sort (successive pile sort procedure), in which respondents sorted 39 nonbasic activities of daily living (non-BADL) and noninstrumental activities of daily living (non-IADL) tasks into four categories: "never performed," "used to but no longer perform," "hard to do," and "easy to do." Lifestyle-adjusted function was defined as the number reported easy/(number easy + number hard + number no longer performed). Results: Respondents reported that they found it easy to perform about 60% of the activities they ever performed. However, people reporting BADL and IADL disability found it easy to perform only 32% of these activities. Lower extremity performance and depressive symptoms were significant independent correlates of lifestyle-adjusted function in models that controlled for sociodemographic and clinical status. The same 2 correlates were significant in models that excluded people with self-reported BADL or IADL disability. Implications: Because this measure eliminates activities never performed, it can be considered "lifestyle adjusted." Its ability to identify differences in competency among people who do not report BADL or IADL disability suggests that it may be a useful addition to functional assessment.

Keywords: Disability, Function, BADL, IADL, Epidemiology of aging

Received November 13, 2008; Accepted February 2, 2009

Decision Editor: William J. McAuley, PhD

Updated to correct quotation marks on Page 1.


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