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Biomedical subjects

S E Doble

Publications and source records attributed to S E Doble.

5 recordsLinked to original sources

Assessing the ADL functioning of persons with Alzheimer's disease: comparison of family informants' ratings and performance-based assessment findings.

The activities of daily living (ADL) functioning of 26 subjects with Alzheimer's disease was measured using the Assessment of Motor and Process Skills (AMPS) and family informants' Older Americans Resources and Services (OARS) Activities of Daily Living (ADL) reports. Concordance with a clinician's ratings of subjects' level of ADL functioning was achieved for 77% of the subjects based on their AMPS ADL process ability measures and for 54% for the subjects based on their family informants' OARS ADL ratings. In cases of discordance, subjects' AMPS ADL process ability measures were just as likely to overestimate (11.5%) as to underestimate (11.5%) subjects' ADL functioning. In contrast, 46% of the informants overestimated their family members' ADL functioning, and this was more likely to occur when subjects' cognitive impairment was mild.

Activities of Daily Living↗

The dimensionality and validity of the Older Americans Resources and Services (OARS) Activities of Daily Living (ADL) Scale.

The psychometric properties of the OARS ADL scale, comprised of seven physical activities of daily living (PADL) and seven instrumental activities of daily living (IADL) items, were examined using a Rasch measurement approach. Two of the PADL items failed to demonstrate acceptable goodness-of-fit with the measurement model but the remaining 12 items could be combined into a single measure of ADL ability. Although the OARS ADL scale was designed to identify those community-dwelling elderly who need supports and services to continue to live in the community, the scale items were found to be poorly targeted to community-dwelling elderly since almost half of our sample received maximal scores. Rasch analysis identified how we might improve the sensitivity of the OARS ADL scale but its utility in outcome and longitudinal studies remains questionable.

Activities of Daily Living↗

Measuring functional competence in older persons with Alzheimer's disease.

Despite their limitations, mental status tests and self/proxy reports of instrumental activities of daily living (IADL) are often used to predict functional competence. In contrast, the Assessment of Motor and Process Skills (AMPS) is a direct observational assessment of IADL competence. Sixty-four community-dwelling elderly (20 Alzheimer's disease [AD] patients and 44 nondemented) were assessed with the AMPS, the Mini-Mental State Examination (MMSE), and the Older Americans Resources and Services (OARS)-IADL. Performance on all three assessments was significantly lower for the AD sample. The MMSE did not correlate significantly with the AMPS motor ability measures but it correlated modestly with the AMPS process ability measures. The OARS-IADL correlated significantly with the AMPS motor ability measure for the nondemented sample alone. Although mental status and self/proxy assessments provide some insight into individuals' IADL competence, direct observation of IADL task performance provides additional information regarding the subtle process and motor skills changes that occur in progressive dementing conditions.

Activities of Daily Living↗

Functional competence of community-dwelling persons with multiple sclerosis using the assessment of motor and process skills.

The Assessment of Motor and Process Skills (AMPS) is an observational measure of functional competence in instrumental activities of daily living (IADL) that was designed to overcome the limitations of self reports and proxy reports. The AMPS allows simultaneous evaluation of the underlying motor and process (organizational/adaptive) skills necessary for competent task performance. We examined the IADL performance of 22 community-dwelling patients with mild to moderate MS in comparison to nondisabled subjects matched for age and gender. Functional competence of the MS subjects, as measured by the AMPS, was poorer than that of the control group. Many MS subjects who would not have been expected to have IADL difficulties on the basis of ratings of neurologic impairment were impaired in their IADL performance. For some patients, IADL impairment reflected deficits in their motor and process skills, whereas for others, process skill impairments alone were responsible for deficient task performance.

Activities of Daily Living↗