OBJECTIVE: To compare activities of daily living (ADL) staging based on 2-level responses to ADL difficulty questions (simple ADL stages) with ADL staging based on 4-level ADL question responses (complex ADL stages). DESIGN: Analysis of the Second Longitudinal Study of Aging, a prospective cohort study, using descriptive statistics and logistic regression. SETTING: Participants' homes. PARTICIPANTS: Community-dwelling persons (N=9447) aged ≥70 years in 1994. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: (1) Agreement and face validity: baseline simple ADL stage; (2) construct validity: baseline health, difficulty, and need characteristics; (3) prognostic comparison (determined at the Wave 2 interview): primary-nursing home use and/or death; secondary-death. RESULTS: The systems showed good agreement (κ=.75). The simple ADL stages stratified people into distinct groups and reflected the expected stepwise increases from stage 0 to stage IV in health and need characteristics, such as the prevalence of home-related challenges (2.9%-84.5%) and perceived need for home modifications (2.1%-33.6%). In comparing the prognostic ability using the primary outcome, the complex system model demonstrated slightly increased discrimination between milder stages and a slightly higher C statistic (.666 vs .664). CONCLUSIONS: Although complex staging appears slightly better at classifying people into distinct prognostic strata with respect to nursing home use and/or death at Wave 2, simple ADL stages demonstrate strong, clinically relevant associations with health and need characteristics.
OBJECTIVE: To compare activities of daily living (ADL) staging based on 2-level responses to ADL difficulty questions (simple ADL stages) with ADL staging based on 4-level ADL question responses (complex ADL stages). DESIGN: Analysis of the Second Longitudinal Study of Aging, a prospective cohort study, using descriptive statistics and logistic regression. SETTING:Participants' homes. PARTICIPANTS: Community-dwelling persons (N=9447) aged ≥70 years in 1994. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: (1) Agreement and face validity: baseline simple ADL stage; (2) construct validity: baseline health, difficulty, and need characteristics; (3) prognostic comparison (determined at the Wave 2 interview): primary-nursing home use and/or death; secondary-death. RESULTS: The systems showed good agreement (κ=.75). The simple ADL stages stratified people into distinct groups and reflected the expected stepwise increases from stage 0 to stage IV in health and need characteristics, such as the prevalence of home-related challenges (2.9%-84.5%) and perceived need for home modifications (2.1%-33.6%). In comparing the prognostic ability using the primary outcome, the complex system model demonstrated slightly increased discrimination between milder stages and a slightly higher C statistic (.666 vs .664). CONCLUSIONS: Although complex staging appears slightly better at classifying people into distinct prognostic strata with respect to nursing home use and/or death at Wave 2, simple ADL stages demonstrate strong, clinically relevant associations with health and need characteristics.
Authors: Margaret G Stineman; Richard N Ross; Roger Fiedler; Carl V Granger; Greg Maislin Journal: Arch Phys Med Rehabil Date: 2003-01 Impact factor: 3.966
Authors: Margaret G Stineman; Richard N Ross; Roger Fiedler; Carl V Granger; Greg Maislin Journal: Arch Phys Med Rehabil Date: 2003-01 Impact factor: 3.966
Authors: Margaret G Stineman; Joel E Streim; Qiang Pan; Jibby E Kurichi; Sophia Miryam Schüssler-Fiorenza Rose; Dawei Xie Journal: PM R Date: 2014-05-02 Impact factor: 2.298
Authors: Sophia Miryam Schüssler-Fiorenza Rose; Margaret G Stineman; Qiang Pan; Hillary Bogner; Jibby E Kurichi; Joel E Streim; Dawei Xie Journal: Health Serv Res Date: 2016-03-17 Impact factor: 3.402
Authors: Sophia Miryam Schüssler-Fiorenza Rose; Dawei Xie; Joel E Streim; Qiang Pan; Pui L Kwong; Margaret G Stineman Journal: BMC Health Serv Res Date: 2016-10-01 Impact factor: 2.655