Construct validity of the late life function and disability instrument for adults with chronic conditions

Responsiveness of the late life disability instrument to pulmonary rehabilitation in people with COPD

PURPOSE

To establish the responsiveness of the disability component of the Late Life Function and Disability Instrument (LLDI) and its Computer Adaptive Test (LLDI-CAT) in people with chronic obstructive pulmonary disease (COPD).

METHOD

Participants completed the LLDI, LLDI-CAT and measures of physical function, health-related quality of life (HRQOL) and symptom severity before and after pulmonary rehabilitation (PR), and global rating of change (GRC) scales at the end of PR. Responsiveness was explored by calculating correlations between LLDI and LLDI-CAT change scores and change scores on the other measures, and calculating the area under the receiver operating characteristic curve (AUC) for the ability of the LLDI and LLDI-CAT to discriminate between participants who were improved versus unchanged. We hypothesized fair correlations (-0.3 to -0.5 or 0.3 to 0.5) with other measures and considered an AUC≥0.7 acceptable. Minimal important differences (MIDs) were estimated using anchor- and distribution-based approaches.

RESULTS

Fifty participants (mean (SD) age 69.8 (7.9) years) completed the study. Only the limitation dimension of the LLDI showed improvement at follow-up (z = 2.4, p = 0.018) and was able to discriminate between participants who were improved versus unchanged (AUC 0.7 (95% CI 0.6-0.9)). Correlations between change scores were as hypothesized between the participation measures and measures of at least two other constructs.

CONCLUSION

This study provides MID values for the LLDI and LLDI-CAT to support their clinical application. The limitation dimension of the LLDI appears to be particularly responsive to PR in people with COPD.

A Tool to Assess Participation in People With COPD: Validation of the Late Life Disability Instrument

BACKGROUND

Participation in life roles is a critical patient-centered health outcome associated with morbidity and mortality in older adults, but it is not measured routinely in people with COPD. We aimed to validate a participation measure, the Late Life Disability Instrument (LLDI), in people with COPD.

RESEARCH QUESTION

To what extent does the LLDI demonstrate test-retest measurement error and reliability, internal consistency, construct and face validity, and floor or ceiling effects when applied to people with COPD?

STUDY DESIGN AND METHODS

In this cross-sectional study, LLDI scores were compared with scores on measures of theoretically related constructs and between groups based on symptom severity, prognosis, and frailty. A subsample (n = 36) completed the LLDI a second time over the phone within one week. Participants and health-care professionals were asked about the relevance, comprehensiveness, and comprehensibility of the LLDI. Floor and ceiling effects were explored, and the internal consistency (Cronbach's α) of the LLDI was calculated.

RESULTS

Ninety-six older adults with COPD participated. The frequency and limitation domains of the LLDI showed excellent test-retest reliability (two-way random effect intraclass correlation coefficient, 0.90 [standard error of measurement, 1.74 points] and 0.90 [standard error of measurement, 3.16 points], respectively). Both domains showed fair correlations with physical function, depression, and quality of life (r = 0.38-0.59). The relationship with anxiety was poor for the LLDI frequency domain (r = -0.21) and fair for LLDI limitation domain (r = -0.45). Both domains discriminated between people with different symptom severity, prognosis, and frailty (P ≤ .026). Neither domain showed floor or ceiling effects, and Cronbach's α was 0.69 and 0.91 for the LLDI frequency and limitation domains, respectively. All healthcare professionals and most participants agreed that the LLDI measures participation (79%) and that the items were relevant (81%).

INTERPRETATION

The LLDI shows test-retest reliability, internal consistency, and construct and face validity in people with COPD. The LLDI can be used to assess participation in this population.

Biobehavioral Intervention Targeting Physical Activity Behavior Change for Older Veterans after Nontraumatic Amputation: A Randomized Controlled Trial

BACKGROUND

Lower-limb amputation (LLA) due to non-traumatic vascular etiology is linked to extremely low physical activity and high disability.

OBJECTIVE

To test the feasibility of a biobehavioral intervention designed to promote physical activity.

DESIGN

A randomized, single-blind feasibility trial with a crossover design.

SETTING

Veterans Administration Medical Center.

PARTICIPANTS

Military veterans (age: 65.7 [7.8] years; mean [standard deviation]) with nontraumatic lower-limb amputation (LLA), randomized to two groups: GROUP1 (n = 16) and GROUP2 (n = 15). Both groups had similar baseline amputation characteristics (level of amputation and time since amputation).

INTERVENTIONS

Twelve weekly, 30-minute telehealth sessions of physical activity behavior-change intervention, with GROUP1 participating in weeks 1-12 and GROUP2 in weeks 13-24. GROUP1 noncontact phase in weeks 13-24 and GROUP2 attention control telehealth phase in weeks 1-12.

MAIN OUTCOME MEASURES

Feasibility (participant retention, dose goal attainment, intervention acceptability [Intrinsic Motivation Inventory [IMI] Interest and Enjoyment scale], safety) and signal of efficacy (free-living physical activity [accelerometer-based average daily step count], Late Life Function and Disability Index - Disability Scale [LLFDI-DS]).

RESULTS

Participant retention rate was high (90%), with three participants lost to follow-up during the intervention period. Dose goal attainment was low, with only 10% of participants achieving an a priori walking dose goal. Intervention was rated as acceptable, with mean IMI Interest and Enjoyment score (5.8) statistically higher than the null value of 5.0 (P = .002). There were no between-group differences in adverse event rates (falls: P = .19, lower extremity wounds: P = .60). There was no signal of efficacy for change in average daily step count (d = -0.15) or LLFDI-DS (d = -0.22 and 0.17 for frequency and limitations scales, respectively).

CONCLUSIONS

Telehealth delivered biobehavioral intervention resulted in acceptable participant retention, low dose goal attainment, high participant acceptability, and low safety risk, while having no signal of efficacy (physical activity, disability) for people with nontraumatic LLA.

Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review

Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons' perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users' preferences, implies a person-centred approach.Implications for rehabilitationThe integration of digital assistive and welfare technology should be based on older persons' needs, and those needs must be assessed using reliable and relevant instruments.The heterogeneity of the target group, i.e. older persons, together with the fact that assessments must give consideration to identifying goals, obstacles and risks as well as users' preferences, implies a person-centred approach.The ideal would be one coherent model that explores the use of digital assistive and welfare technology from the individual, economic as well as organisational dimensions. This would cover the different needs and expectations of various stakeholders, including economic and organisational, but also the needs of the older person.

Validation and responsiveness of the Late-Life Function and Disability Instrument Computerized Adaptive Test in community-dwelling stroke survivors

BACKGROUND

Follow-up of stroke survivors is important to objectify activity limitations and/or participations restrictions. Responsive measurement tools are needed with a low burden for professional and patient.

AIM

To examine the concurrent validity, floor and ceiling effects and responsiveness of both domains of the Late-Life Function and Disability Index Computerized Adaptive Test (LLFDI-CAT) in first-ever stroke survivors discharged to their home setting.

DESIGN

Longitudinal study.

SETTING

Community.

POPULATION

First ever stroke survivors.

METHODS

Participants were visited within three weeks after discharge and six months later. Stroke Impact Scale (SIS 3.0) and Five-Meter Walk Test (5MWT) outcomes were used to investigate concurrent validity of both domains, activity limitations, and participation restriction, of the LLFDI-CAT. Scores at three weeks and six months were used to examine floor and ceiling effects and change scores were used for responsiveness. Responsiveness was assessed using predefined hypotheses. Hypotheses regarding the correlations with change scores of related measures, unrelated measures, and differences between groups were formulated.

RESULTS

The study included 105 participants. Concurrent validity (R) of the LLFDI-CAT activity limitations domain compared with the physical function domain of the SIS 3.0 and with the 5MWT was 0.79 and -0.46 respectively. R of the LLFDI-CAT participation restriction domain compared with the participation domain of the SIS 3.0 and with the 5MWT was 0.79 and -0.41 respectively. A ceiling effect (15%) for the participation restriction domain was found at six months. Both domains, activity limitations and participation restrictions, of the LLFDI-CAT, scored well on responsiveness: 100% (12/12) and 91% (12/11) respectively of the predefined hypotheses were confirmed.

CONCLUSIONS

The LLFDI-CAT seems to be a valid instrument and both domains are able to detect change over time. Therefore, the LLFDI-CAT is a promising tool to use both in practice and in research.

CLINICAL REHABILITATION IMPACT

The LLFDI-CAT can be used in research and clinical practice.

Validity, Reliability, and Diagnostic Accuracy of Ratings of Perceived Exertion to Identify Dependence in Performing Self-care Activities in Older Women

BACKGROUND

Dependence in self-care activities among older women has been previously evaluated through performance-based tests. However, these tests have presented inability to accurately distinguish between dependent and independent older adults in performing activities of daily living.

AIM

To examine the validity, reliability, and diagnostic accuracy of rating of perceived exertion (RPE) to identify dependence in performing self-care activities in older women.

METHODS

Thirty-five older women performed two different constant-load tasks (walking on treadmill at 4 km/h for five minutes and arm curls with two kg for one minute), reporting RPE at the end, in four sessions. Performance-based tests (30-second chair stand and 6-minute walk) were also evaluated. Katz Index and Lawton and Brody questionnaires were applied to evaluate the dependence level in performing basic and instrumental activities of daily living.

RESULTS

RPE was greater on the first session (RPE 14 ± 2) than second session (RPE 13 ± 2), while it was similar through other sessions, with high values of intraclass coefficient correlation (0.96-0.99). Basic activities of daily living and instrumental activities of daily living presented high correlations with RPE measures (0.75-0.82), whereas performance-based tests presented moderate correlations (0.47-0.59). RPE responses explained the most variance in identifying dependence in self-care activities and presented high diagnostic accuracy to differentiate dependent from independent older women. So the hypotheses had been confirmed that RPE responses in constant-load exercise are better predictors of dependence in self-care activities than performance-based tests.

CONCLUSIONS

RPE of constant-load physical tasks was valid, reliable, and accurate in identifying dependence in performing self-care activities in older women; therefore, it is possible to use the perceived exertion to identify dependence in performing activities of daily living in older women.

Measuring participation in patients with chronic back pain-the 5-Item Pain Disability Index

BACKGROUND CONTEXT

Of the three broad outcome domains of body functions and structures, activities, and participation (eg, engaging in valued social roles) outlined in the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF), it has been argued that participation is the most important to individuals, particularly those with chronic health problems. Yet, participation is not commonly measured in back pain research.

PURPOSE

The aim of this study was to investigate the construct validity of a modified 5-Item Pain Disability Index (PDI) score as a measure of participation in people with chronic back pain.

STUDY DESIGN

A validation study was conducted using cross-sectional data.

PATIENT SAMPLE

Participants with chronic back pain were recruited from a multidisciplinary pain center in Alberta, Canada.

OUTCOME MEASURES

The outcome measure of interest is the 5-Item PDI.

METHODS

Each study participant was given a questionnaire package containing measures of participation, resilience, anxiety and depression, pain intensity, and pain-related disability, in addition to the PDI. The first five items of the PDI deal with social roles involving family responsibilities, recreation, social activities with friends, work, and sexual behavior, and comprised the 5-Item PDI seeking to measure participation. The last two items of the PDI deal with self-care and life support functions and were excluded. Construct validity of the 5-Item PDI as a measure of participation was examined using Pearson correlations or point-biserial correlations to test each hypothesized association.

RESULTS

Participants were 70 people with chronic back pain and a mean age of 48.1 years. Forty-four (62.9%) were women. As hypothesized, the 5-Item PDI was associated with all measures of participation, including the Participation Assessment with Recombined Tools-Objective (r=-0.61), Late-Life Function and Disability Instrument: Disability Component (frequency: r=-0.66; limitation: r=-0.65), Work and Social Adjustment Scale (r=0.85), a global perceived participation scale (r=0.54), employment status (r=-0.30), and the Usual Activity domain of the 15D (r=0.50). The expected correlations observed indicating a moderate or strong association provided supporting evidence for the construct validity of the 5-Item PDI as a measure of participation. The Oswestry Disability Index and the 5-Item PDI were also strongly correlated (r=0.70). The 5-Item PDI was associated to a lesser degree with depressive symptoms and resilience, as measured by the Hospital Anxiety and Depression Scale (HADS) (r=0.25) and the Connor-Davidson Resilience Scale (r=-0.28), as would be expected. No statistically significant association was found between the 5-Item PDI and the HADS Anxiety score.

CONCLUSIONS

It is important that outcome measures of participation are included in back pain research to gauge the effects of painful spinal conditions and interventions on maintaining valued social roles. A simple, concise measure would be very useful for this purpose in clinical and research settings. The results of this study support the construct validity of the 5-Item PDI as a brief measure of participation in people with chronic back pain. These findings are likely most applicable to those with chronic back pain attending pain clinics and other tertiary centers for care.

Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test

BACKGROUND

Adequate and user-friendly instruments for assessing physical function and disability in older adults are vital for estimating and predicting health care needs in clinical practice. The Late-Life Function and Disability Instrument Computer Adaptive Test (LLFDI-CAT) is a promising instrument for assessing physical function and disability in gerontology research and clinical practice.

OBJECTIVE

The aims of this study were: (1) to translate the LLFDI-CAT to the Dutch language and (2) to investigate its validity and reliability in a sample of older adults who spoke Dutch and dwelled in the community.

DESIGN

For the assessment of validity of the LLFDI-CAT, a cross-sectional design was used. To assess reliability, measurement of the LLFDI-CAT was repeated in the same sample.

METHODS

The item bank of the LLFDI-CAT was translated with a forward-backward procedure. A sample of 54 older adults completed the LLFDI-CAT, World Health Organization Disability Assessment Schedule 2.0, RAND 36-Item Short-Form Health Survey physical functioning scale (10 items), and 10-Meter Walk Test. The LLFDI-CAT was repeated in 2 to 8 days (mean=4.5 days). Pearson's r and the intraclass correlation coefficient (ICC) (2,1) were calculated to assess validity, group-level reliability, and participant-level reliability.

RESULTS

A correlation of .74 for the LLFDI-CAT function scale and the RAND 36-Item Short-Form Health Survey physical functioning scale (10 items) was found. The correlations of the LLFDI-CAT disability scale with the World Health Organization Disability Assessment Schedule 2.0 and the 10-Meter Walk Test were -.57 and -.53, respectively. The ICC (2,1) of the LLFDI-CAT function scale was .84, with a group-level reliability score of .85. The ICC (2,1) of the LLFDI-CAT disability scale was .76, with a group-level reliability score of .81.

LIMITATIONS

The high percentage of women in the study and the exclusion of older adults with recent joint replacement or hospitalization limit the generalizability of the results.

CONCLUSIONS

The Dutch LLFDI-CAT showed strong validity and high reliability when used to assess physical function and disability in older adults dwelling in the community.

Use of the Late-Life Function and Disability Instrument for Measuring Physical Functioning in Patients With Heart Failure

BACKGROUND AND PURPOSE

We evaluated the psychometric properties of the functioning component of the Late-Life Function and Disability Instrument (LLFDI) in individuals with heart failure (HF).

METHODS

Factor analyses were used (N = 151) to assess the dimensionality and structure of the basic and advanced lower extremity function subscales. Rasch model scores were compared to the raw means of the items.

RESULTS

Rasch scores correlated with the raw means of the items at r = .96, indicating raw means are comparable to the more complicated Rasch analysis in estimating physical functioning using the basic and advanced subscales.

CONCLUSIONS

The lower extremity physical functioning subscales of the LLFDI have potential as a clinical assessment tool to identify HF patients who are at high risk for functional limitations.

Psychometric Evaluation of the Physical Activity Enjoyment Scale in Adults with Functional Limitations

Enjoyment is an important construct for understanding physical activity participation, and it has not been examined in adults with functional limitations. This secondary analysis reported the reliability and validity of the Physical Activity Enjoyment Scale (PACES) in a convenience sample of 40 adults with functional limitations. The participants completed the PACES, Center for Epidemiological Studies Depression Scale (CES-D), and the Late Life Function and Disability Instrument (LLFDI) prior to beginning a 12-week feasibility dance intervention study. Results indicated reliability as Cronbach's alpha was .95 and mean inter-item correlation was .52. To further support reliability, homogeneity of the instrument was evaluated using item-to-total scale correlations. Homogeneity was supported as all items had corrected item-to-total correlations greater than .30. For validity, the PACES was significantly related to only the Physical Function component of the LLFDI (r = .38, p = .02), but not the CES-D. Exploratory factor analysis revealed a 3-factor structure that accounted for 73.76% of the variance. This feasibility intervention dance study represented the first attempt to examine the psychometric properties of the PACES in adults with functional limitations. The findings demonstrate support for the scale's reliability and validity among adults with functional limitations. Results are informative as further psychometric testing of the PACES is recommended using randomized clinical trials with larger sample sizes. Enjoyment for physical activity is an important construct for understanding physical activity participation in adults with functional limitations.

Translation and validation of the Arab version of the Late-Life Function and Disability Instrument: a cross sectional study

Background

The Late-Life Function and Disability Instrument (LLFDI) provides a comprehensive, reliable, and valid assessment of physical function and disability in community-dwelling adults. There does not appear to be a validated, comprehensive instrument for assessing function and disability in Arabic. The objective of the present study was to translate and culturally adapt the LLFDI to Arabic, and to determine its test-retest reliability and validity.

Methods

The LLFDI was translated to Arabic through a forward and backward translation process, and approved by a bilingual committee of experts. Sixty-one (26 male and 35 female) Arabic speaking, healthy, older adults, ages 65–88, living in northern Israel participated in the study. To determine test-retest reliability, the questionnaire was administered twice to 41 subjects with a 6 to 8day interval. Construct validity was examined by correlating the LLFDI responses with the 10-item physical function (PF-10) subscales of the General Health Survey (SF-36), with the physical component of SF-36 (SF-36 PCS), and with two performance measures, the Berg Balance Scale (BBS) and Time Up and Go (TUG) test. Additionally, gender and fall related differences in the LLFDI were also examined.

Results

Internal consistency (Cronbach’s alpha) was good to excellent (0.77 to 0.97). Test-retest agreement was good to very good (function component: 0.86–0.93, disability component: 0.77–0.93). Correlation with the SF-36 PCS and PF-10 was moderate to strong for both LLFDI components (function, r = 0.53–0.65 and r = 0.57–0.63, and LLFDI disability, r = 0.57–0.76 and 0.53–0.73, respectively). Significant, moderate-to-strong correlations between the LLFDI and BBS (r = 0.73–0.87) and a significant, moderate, negative correlation between LLFDI and TUG test (r = −0.59– -0.68) were noted. The standard error of measure was 6–12%, and the smallest real difference was 18–33%. Discriminative validity for both gender and fall status were also demonstrated.

Conclusions

The Arabic version of the LLFDI is a highly reliable and valid instrument for assessing function and disability in community dwelling, Arab older adults. The translated instrument has a discriminative ability between genders and between fallers and non-fallers. The translated instrument may be used in clinical settings and for research purposes.

Evaluation of the Late-Life Disability Instrument (LLDI) in low-income older populations

OBJECTIVE

To assess the construct and convergent validity of the 16 items of the Late-Life Disability Instrument (LLDI) in Latin American seniors.

METHOD

Exploratory and confirmatory factor analyses were performed to assess the factor structure of frequency and limitation sub-scales of the LLDI. ANOVA and t test were used to determine the convergent and construct validity of the LLDI by exploring associations with physical performance tests, mobility limitations, depression, cognition, self-reported health, as well as with sex, education, and income.

RESULTS

Factor analysis resulted in one-factor solution and acceptable model fit. Participants with better physical function, less mobility limitations, better self-reported health, and intact cognition reported more frequent activities and fewer limitations, indicating good convergent and construct validity of our measure.

CONCLUSION

LLDI is a good instrument to assess disability in low-income populations. Further research is needed to include culturally acceptable activities for the frequency sub-scale.

Self-reported function and disability in late life - cross-cultural adaptation and validation of the Swedish version of the late-life function and disability instrument

Purpose

To translate and perform a cross-cultural adaptation of the Late-Life Function and Disability Instrument (LLFDI) to Swedish, to investigate absolute and relative reliability, concurrent validity, and floor and ceiling effects within a Swedish-speaking sample of community-dwelling older adults with self-reported balance deficits and fear of falling.

Method

Translation, reliability and validation study of the LLFDI. Sixty-two community-dwelling, healthy older adults (54 women and 8 men) aged 68–88 years with balance deficits and fear of falling performed the LLFDI twice with an interval of 2 weeks.

Results

Test–retest agreement, intra-class correlation coefficient was very good, 0.87–0.91 in the LLFDI function component and 0.82–0.91 in the LLFDI disability component. The standard error of measure was small, 5–9%, and the smallest real difference was 14–24%. Internal consistency (Cronbach’s alpha) was high (0.90–0.96). Correlation with the SF-36 PCS and PF-10 was moderate in both LLFDI function, r = 0.39–0.68 and r = 0.35–0.52, and LLFDI disability, r = 0.40–0.63 and 0.34–0.57, respectively. There was no floor or ceiling effects.

Conclusion

The Swedish version of the LLFDI is a highly reliable and valid instrument for assessing function and disability in community-dwelling older women with self-reported balance deficits and fear of falling.

Implications for Rehabilitation

The Swedish LLFDI is a highly reliable and valid instrument for assessing function and disability in older women with self-reported balance deficits and fear of falling.

The instrument may be used both in clinical settings and in research.

The instrument is sensitive to change and a reasonably small improvement is enough to detect changes in a group or a single individual.

Utility of the late life function and disability instrument as an outcome measure in patients participating in outpatient cardiac rehabilitation: a preliminary study

PURPOSE

The purpose of this study was to examine the concurrent validity of the Late Life Function and Disability Instrument (LLFDI) in patients with coronary heart disease (CHD) and to evaluate the accuracy of information obtained through self-report questionnaire versus interview formats.

METHODS

The study included 29 patients older than 60 years attending an outpatient cardiac rehabilitation program. Participants completed the LLFDI, three additional self-report criterion measures, and six performance-based tests; they completed the LLFDI a second time via interview. We used descriptive statistics, correlations, and t-tests to analyze the data.

RESULTS

All LLFDI components were correlated (rs=0.36-0.83) with the self-report criterion measures. The Function Component of the LLFDI was moderately correlated with the 6-Minute Walk Test (r=0.62), timed up-and-go (r=-0.58), walking speed (r=-0.57), and timed sit-to-stand (r=-0.56) scores. The LLFDI demonstrated a ceiling effect (10%) only in the Disability Limitation component. All LLFDI component scores obtained via self-report questionnaire were correlated with scores obtained via interview; except in a single subcategory, there was no difference between LLFDI scores obtained through self-report questionnaire and those obtained through interview.

CONCLUSIONS

RESULTS indicate that the LLFDI has appropriate validity for older patients (>60 years) with CHD and can be completed independently by patients rather than administered by clinicians.

Late life function and disability instrument in African American women: function component

Obesity, age, and comorbidity can lead to limitations in physical function, especially in middle aged, community-dwelling, African American women. To determine the clinical implications of limitations in physical function, instruments that assess physical function need to be tested in this population. The purpose of the authors in this secondary analysis was to report the internal consistency and validity of the Physical Function component of the Late Life Function and Disability Instrument in middle-aged, community-dwelling, African American women. In 2006, 126 community-dwelling African American women completed the Physical Function component, the Physical Activity Scale for the Elderly, and the 6 Minute Walk Test at baseline. Results indicated Cronbach's alphas were excellent (all >.92) for the Physical Function component and the three subscales. The Physical Function component correlated directly with the Physical Activity Scale for the Elderly (r = .37, p < .01) and the 6 Minute Walk Test (r = .36, p < .01) but was inversely correlated with age (r = -.42, p < .01) and comorbidity (r = -.35, p < .01). However, obesity was not correlated (r = -.11, p > .05). A three-factor structure of the Physical Function component was confirmed. Thus, the Physical Function component was a reliable and valid measure to screen African American women who were at risk for function limitations. Future recommendations are discussed.