Table 1.
Instrumental activities of daily living scales devised for use in low- and middle-income countries
| Author, year | Location, setting | Development method | Validation sample | Validation method | Key findings |
|---|---|---|---|---|---|
| Senanarong et al., 2003 (THAI-ADL) (28) | Thailand, community and specialist clinic | Specialist panel discussion | 181 memory clinic attendees; mean age 69 years | Agreement with Thai MMSE FAQ, Barthel, CDR | Correlation with Thai MMSE (r=0.69), CDR (r=0.81), Barthel Index (r=0.80) and FAQ (r=0.88) |
| Jitapunkul et al., 1994 (Chula ADL) (29) | Thailand, community sample | Factor analysis of items from the Barthel index and Office of Populations Censuses and Surveys (OPCS) disability score | 703 people aged 60 years and over; mean age 68 years | Agreement with OPCS and Barthel Index | Aim of scale was to measure disability appropriately in local population |
| Umayal et al., 2010 (30) | Sri Lanka, nursing home population | Validation of a modified Blessed dementia scale and Bristol ADL. Scores were modified by expert/clinician opinion | Nursing home residents aged 65 years and over; mean age 73 years | Dementia ICD-10 criteria by consultant psychiatrist | Modified Bristol scale: AUROC 0.933. Sensitivity 100%, specificity 74.2% Modified Blessed scale: AUROC 0.892. Sensitivity 100%, specificity 71% |
| Fillenbaum et al., 1999 (EASI) (31) | Kerala, India low-literacy community | Community discussion with elders and health workers related to usual social roles and activities of the elderly | Pilot testing 100 people, initial validation 387 people aged 55 years and over; mean age 69.5 years | Hindi MMSE score< 22 | Cronbach's alpha = 0.82. Lower scores in females, older people, illiterate people and those with lower cognitive function |
| Mathuranath et al., 2005 (E-ADL) (32) | India memory clinic | Development and validation of scale based on Lawton IADL. Input from senior citizens group and clinicians on suitable IADL | Validation on 240 memory clinic attendees and 135 controls from background population | DSM dementia | AUROC 0.97. Sensitivity 0.91, specificity 0.99 |
| Hendrie et al., 2006 (CHIF) (14) | Nigeria | Expert opinion of clinicians. Also took into account ‘items usually included in assessments of ADL’ | Community sample of 295 | DSM dementia Blessed dementia scale, MMSE |
AUROC 0.925 for dementia Cronbach's alpha 0.83 Correlated with Blessed DS 0.56 and MMSE 0.44 |