The online version of this article (doi:10.1186/1471-2318-14-12) contains supplementary material, which is available to authorized users.
AMJ has stock holdings in CREcare, LLC, a small business created to disseminate outcome instruments such as the LLFDI.
MKB was responsible for the conception, design and coordination of the study, data acquisition and interpretation, and drafting and revising the manuscript. CTS contributed to the acquisition of data and revision of the manuscript. MMP contributed to the acquisition of data and revision of the manuscript. JFB contributed to the general supervision of the study, conception, design, interpretation of data and revision of the manuscript. AMJ contributed to the general supervision of the study, conception, design, interpretation of data and revision of the manuscript. All authors approved the final manuscript.
The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties. The Late-Life Function and Disability Instrument (LLFDI) has been widely used to assess functional limitations and disability in studies with older adults. The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI.
Published studies of any design reporting results based on administration of the original version of the LLFDI in community-dwelling older adults were identified after searches of 9 electronic databases. Data related to construct validity (convergent/divergent and known-groups validity), test-retest reliability and sensitivity to change were extracted. Effect sizes were calculated for within-group changes and summarized graphically.
Seventy-one studies including 17,301 older adults met inclusion criteria. Data supporting the convergent/divergent and known-groups validity for both the Function and Disability components were extracted from 30 and 18 studies, respectively. High test-retest reliability was found for the Function component, while results for the Disability component were more variable. Sensitivity to change of the LLFDI was confirmed based on findings from 25 studies. The basic lower extremity subscale and overall summary score of the Function component and limitation dimension of the Disability component were associated with the strongest relative effect sizes.
There is extensive evidence to support the construct validity and sensitivity to change of the LLFDI among various clinical populations of community-dwelling older adults. Further work is needed on predictive validity and values for clinically important change. Findings from this review can be used to guide the selection of the most appropriate LLFDI subscale for use an outcome measure in geriatric research and practice.
Additional file 1: Outlines data extraction results for each study in Tables S1, S2 and S3 as per below. Table S1. Characteristics of studies reporting results based on the administration of the Late Life Function and Disability Instrument. Table S2. Convergent/divergent validity of the Late-Life Function and Disability Instrument. Table S3. Sensitivity to change of the Late-Life Function and Disability Instrument. (DOC 214 KB)
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- Psychometric properties of the Late-Life Function and Disability Instrument: a systematic review
Marla K Beauchamp
Catherine T Schmidt
Mette M Pedersen
Jonathan F Bean
Alan M Jette
- BioMed Central
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