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Tomita N, Ohashi Y, Ishiki A, Ozaki A, Nakao M, Ebihara S, Taki Y. Detecting Comparative Features of Comprehensive Geriatric Assessment through the International Classification of Functioning, Disability, and Health Linkage: A Web-Based Survey. J Clin Med 2023; 12:4917. [PMID: 37568319 PMCID: PMC10419489 DOI: 10.3390/jcm12154917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
Multidimensional assessments are important in evaluating the overall health of older adults. The comprehensive geriatric assessment (CGA) is a representative framework; however, the burden associated with the CGA has led to the development of simplified multidimensional tools. Comparing these tools to the CGA can help utilize them effectively. However, a direct comparison is challenging owing to the conceptual nature of the CGA. In this study, we conducted a web-based survey to identify essential CGA components by linking International Classification of Functioning, Disability, and Health (ICF) category level 2 items and "not defined/not covered" (nd/nc) items. Healthcare professionals and individuals aged >65 years participated in a two-stage Delphi study. In total, 182 respondents (7 geriatricians, 22 nurses, 20 therapists, and 4 case managers) completed the survey. Sixty-one essential components for CGA were identified, including 55 ICF categories. Additionally, personal factors (i.e., proactiveness) and nd/nc items (i.e., subjective perceptions) were aggregated. The results suggest that the CGA includes objective conditions of intrinsic capacity, functional ability, and environment as well as subjective perceptions and proactiveness toward those conditions. Thus, CGA is not merely expected to assess geriatric syndrome but also to estimate broader concepts, such as interoception, resilience, and quality of life.
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Affiliation(s)
- Naoki Tomita
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai 980-8575, Miyagi, Japan
- Department of Aging Research and Geriatric Medicine, Division of Brain Science, Institute of Development, Aging, and Cancer (IDAC), Tohoku University, Sendai 980-8575, Miyagi, Japan
| | - Yuki Ohashi
- Nursing Department, Rakuwakai Otowa Rehabilitation Hospital, Kyoto City 607-8062, Kyoto Prefecture, Japan
| | - Aiko Ishiki
- Department of Community Medicine, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Miyagi, Japan
| | - Akiko Ozaki
- Department of Gerontological and Home Healthcare Nursing, Division of Health Sciences, Graduate School of Medicine, Tohoku University, Sendai 980-8575, Miyagi, Japan
| | - Mitsuyuki Nakao
- Laboratory of Biomodeling, Department of Applied Information Sciences, Graduate School of Information Sciences, Tohoku University, Sendai 980-8579, Miyagi, Japan
- Unprecedented-Scale Data Analytics Center, Tohoku University, Sendai 980-8579, Miyagi, Japan
| | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Graduate School of Medicine, Tohoku University, Sendai 980-857, Miyagi, Japan;
| | - Yasuyuki Taki
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai 980-8575, Miyagi, Japan
- Department of Aging Research and Geriatric Medicine, Division of Brain Science, Institute of Development, Aging, and Cancer (IDAC), Tohoku University, Sendai 980-8575, Miyagi, Japan
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Jiang C, Zou M, Chen M, Jiang Y, Chang P, Cui Y, Jiang L. Reliability and validity of the Mandarin version of the Continuity Assessment Record and Evaluation for older people who are transferred between hospitals and nursing homes in China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1180-1189. [PMID: 32048425 DOI: 10.1111/hsc.12951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 06/10/2023]
Abstract
To date, assessment tools for older people are different between hospitals and nursing homes in China. The difference between assessment tools can lead to poor communication of information between hospitals and nursing homes, which causes discontinuity of care and adverse outcomes when older people are transferred between these different settings. Continuity Assessment Record and Evaluation (CARE) is a comprehensive geriatric assessment tool developed in the United States of America. This study aimed to evaluate the reliability and validity of the Mandarin Version of CARE for older people who are transferred between hospitals and nursing homes. Using a convenience sampling method, 120 older people in hospitals and 120 older people in nursing homes in Shanghai were selected to test the internal consistency, interrater reliability and criterion-related validity of CARE from May to November 2017. When used among hospital, 70.0% (7/10) of the subscales had a Cronbach's alpha coefficients of greater than 0.7, 94.3% (50/53) of the items had an intraclass correlation coefficient (ICC) of greater than 0.75. When used in nursing homes, 90.0% (9/10) of the subscales had a Cronbach's alpha coefficients of greater than 0.7, 94.3% (50/53) of the items had an ICC of greater than 0.75. For both settings, the correlation coefficients of the subscales with their corresponding instruments for criterion-related validity were all greater than 0.8 (p < .01). The Mandarin version of CARE exhibits good reliability and validity. It can be used as an assessment tool for transition between hospitals and nursing homes.
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Affiliation(s)
- Caixia Jiang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Min Zou
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | | | - Yijun Jiang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Polun Chang
- Institute of bioMedical Informatics, National Yang-Ming University, Taipei City, Taiwan
| | - Yanyan Cui
- Institute of bioMedical Informatics, National Yang-Ming University, Taipei City, Taiwan
| | - Liping Jiang
- Department of Nursing, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Azzopardi RV, Vermeiren S, Gorus E, Habbig AK, Petrovic M, Van Den Noortgate N, De Vriendt P, Bautmans I, Beyer I. Linking Frailty Instruments to the International Classification of Functioning, Disability, and Health: A Systematic Review. J Am Med Dir Assoc 2016; 17:1066.e1-1066.e11. [PMID: 27614932 DOI: 10.1016/j.jamda.2016.07.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/15/2016] [Accepted: 07/22/2016] [Indexed: 01/01/2023]
Abstract
To date, the major dilemma concerning frailty is the lack of a standardized language regarding its operationalization. Considering the demographic challenge that the world is facing, standardization of frailty identification is indeed the first step in tackling the burdensome consequences of frailty. To demonstrate this diversity in frailty assessment, the available frailty instruments have been linked to the International Classification of Functioning, Disability, and Health (ICF): a standardized and hierarchically coded language developed by World Health Organization regarding health conditions and their positive (functioning) and negative (disability) consequences. A systematic review on frailty instruments was carried out in PubMed, Web of Knowledge, and PsycINFO. The items of the identified frailty instruments were then linked to the ICF codes. 79 original or adapted frailty instruments were identified and categorized into single (n = 25) and multidomain (n = 54) groups. Only 5 frailty instruments (indexes) were linked to all 5 ICF components. Whereas the ICF components Body Functions and Activities and Participation were frequently linked to the frailty instruments, Body Structures, Environmental and Personal factors were sparingly represented mainly in the multidomain frailty instruments. This review highlights the heterogeneity in frailty operationalization. Environmental and personal factors should be given more thought in future frailty assessments. Being unambiguous, structured, and neutral, the ICF language allows comparing observations made with different frailty instruments. In conclusion, this systematic overview and ICF translation can be a cornerstone for future standardization of frailty assessment.
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Affiliation(s)
- Roberta Vella Azzopardi
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium
| | - Sofie Vermeiren
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium
| | - Ellen Gorus
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium
| | - Ann-Katrin Habbig
- Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Fundamental Rights and Constitutionalism Research group (FRC), Vrije Universiteit Brussel (VUB), Elsene, Belgium
| | - Mirko Petrovic
- Geriatrics department, Ghent University Hospital (UZ Gent), Ghent, Belgium
| | | | - Patricia De Vriendt
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Artevelde Hogeschool, Ghent, Belgium
| | - Ivan Bautmans
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium.
| | - Ingo Beyer
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium
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De Vriendt P, Gorus E, Cornelis E, Bautmans I, Petrovic M, Mets T. The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment. J Nutr Health Aging 2013; 17:64-71. [PMID: 23299382 DOI: 10.1007/s12603-012-0381-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Assessment of advanced activities of daily living (a-ADL) can be of interest in establishing the diagnosis of Alzheimer's disease (AD) in an earlier stage, since these activities demand high cognitive functioning and are more responsive to subtle changes. In this study we tested a new a-ADL tool, developed according to the International Classification of Functioning, Disability and Health (ICF). The a-ADL tool is based on the total number of activities performed (TNA) by a person and takes each subject as his own reference. It distinguishes a total disability index (a-ADL-DI), a cognitive disability index (a-ADL-CDI), and a physical disability index (a-ADL-PDI), with lower score representing more independency. We explored whether these indices allow distinction between cognitively healthy persons, patients with Mild Cognitive Impairment (MCI) and patients with mild AD. METHODS Participants were on average 80 years old (SD 4.6; 66-90), were community dwelling, and were diagnosed as (1) cognitively healthy subjects (n=26); (2) patients with MCI (n = 17), or (3) mild AD (n = 25), based upon extensive clinical evaluation and a set of global, cognitive, mood and functional assessments. The a-ADL-tool was not part of the clinical evaluation. RESULTS The a-ADL-CDI was significantly different between the three groups (p<.01). The a-ADL-DI was significantly different between MCI and AD (p<.001). The tool had good psychometrical properties (inter-rater reliability; agreement between patient and proxy; correlations with cognitive tests). Although the sample size was relatively small, ROC curves were computed for the a-ADL-DI and a-ADL-CDI with satisfactory and promising results. CONCLUSION The a-ADL-CDI and a-ADL-DI might offer a useful contribution to the identification and follow up of patients with mild cognitive disorders in an older population.
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Affiliation(s)
- P De Vriendt
- Frailty in Ageing (FRIA) reSearch Group,Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
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De Vriendt P, Gorus E, Bautmans I, Mets T. Conversion of the Mini-Mental State Examination to the International Classification of Functioning, Disability and Health terminology and scoring system. Gerontology 2011; 58:112-9. [PMID: 22067433 DOI: 10.1159/000330088] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 06/16/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In older patients, evaluation of the cognitive status is crucial. The Mini-Mental State Examination (MMSE) is widely used for screening of cognition, providing fairly high sensitivity, specificity and reproducibility. Recently, a consensus emerged on the necessity of an international and transparent language, as provided by the WHO's International Classification of Functioning, Disability and Health (ICF). Most assessment tools however are not in accordance with the ICF. OBJECTIVE To reformulate the MMSE according to the ICF, both for the individual items and for the scoring system. METHOD MMSE data (scores varying from 3 to 30/30) of (1) 217 cognitively healthy elderly, (2) 60 persons with mild cognitive impairment, (3) 60 patients with mild Alzheimer's disease (AD), and (4) 60 patients with moderate/severe AD were obtained from studies at a university hospital setting. Subjects were aged 65 years or more and recruited either through advertisement (group 1), from the geriatric day hospital (groups 2 and 3), or the geriatric ward (group 4). The allocation to the groups was done after multidisciplinary evaluation. The conversion of the MMSE to ICF-MMSE was done by content comparison and by subsequent translation of the scoring system using automatic algorithms. RESULTS All MMSE items were converted to the corresponding ICF categories. Three ICF domains were addressed: global and specific mental functions, general tasks and demands, divided over 6 ICF categories (orientation time/place, sustaining attention, memory functions, mental functions of language, undertaking a simple task). Scores on individual items were transformed according to their relative weight on the original MMSE scale, and a total ICF-MMSE score from 0 (no problem) to 100 (complete problem) was generated. Translation was satisfying, as illustrated by a good correlation between MMSE and ICF-MMSE. The diagnostic groups were distributed over the ICF-MMSE scores as expected. For each ICF domain, ICF-MMSE subscores were higher with increasing severity in cognitive decline. There was a higher dispersion, in accordance with the more detailed scoring possibilities of the ICF-MMSE. CONCLUSIONS It is possible to adapt the MMSE to the ICF concept. This adaptation enhances interdisciplinary communication since it provides more clarity in assessment, with better visibility of the areas covered by the instrument.
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Affiliation(s)
- P De Vriendt
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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