Rasch analysis highlighted relative importance of walking and transferring disabilities among elderly in developing countries

Walk and connect. Measurement of inclusion criteria for people with functional diversity. Ibague, Colombia

The absence of comprehensive and structured planning strategies for pedestrians, especially for those with functional diversity, promotes the need to address tools that allow broadening the spectrum of their assessment and prioritizing the inclusive development of cities. Therefore, this document describes the application of the Transit Oriented Development Standard guide in an area with mixed uses in Ibague city, as an evaluation tool in the analysis of the principles of walking and connecting. For its general understanding, the terms of Transit Oriented Development, walkability and functional diversity are analyzed. Evidence is presented on the need to project balanced intermodal systems that demonstrate the importance of universal accessibility in urban mobility.

Assessing patterns and stability of ADL hierarchical scales for functional disability assessment

BACKGROUND AND OBJECTIVES

This study examined the stability over time of activities of daily living (ADL) items in three comparable longitudinal datasets and evaluated ADL loss sequences for older adults in the U.S., South Korea, and Japan.

RESEARCH DESIGN AND METHODS

Data from the U.S. Health and Retirement Study, and its two international sister surveys, were analyzed. Subjects were community-dwelling adults aged 60 and above. For each dataset, Rasch analysis was implemented to determine if the ordering of items remained stable across multiple waves (2006-2014), such that a single ADL hierarchy may be derived from multi-wave data.

RESULTS

Data fitted the Rasch model well. Item calibrations were sufficiently stable across measurement periods in each dataset, reflecting a stable frame of reference. Results were also robust to sample variations. The derived ADL hierarchies based on scaled logit scores revealed that "dressing" and "bathing" were relatively more difficult items for older adults in all study populations.

DISCUSSION AND IMPLICATIONS

Scale stability is essential when exploiting longitudinal data to analyze patterns in ADL disabilities. The consistency in ADL scales across measurement periods supports their use as screening tools and identifying those at risk for transitions in care. Interventions to reduce dependency in bathing and dressing can help improve independent functioning for community-dwelling elderly.