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TABLE A-3Theoretical Content of Disability Questions Among Surveys on Aging

Survey Question ContentPathology/Condition: ImpairmentFunctioning: Basic ActionsaDisability: Adaptive BehaviorbParticipation: Role FunctioningcEnvironmentd
LSOA—2000
 Nagi functioning questions—any difficultyX [7]
 Nagi functioning questions—level of difficultyX [7]
 ADLs—any difficultyX [6]
 ADLs—amount of difficultyX [6]
 Special equipment usedX [1]
 Type of special equipmentX [6]
 ADLs—receive help or need more helpX [6]
 Need help with ADLsX [6]
 IADLs—any difficultyX [7]
 IADLs—amount of difficultyX [7]
 IADLs—receive help or need more helpX [7]
 IADLs—need helpX [7]
 ConditionsX [list]
  VisioneX [3]
  HearingX [4]
 Cognitive functioningfX [test]
 Mental healthX [3]
 Social behaviorgX [12]
 Leaving homehX [2]
 Housing questionsiX [5]
NLTCS—2004
 Screener
  ADLsX [9]
  IADLsX [7]
 ConditionsX [list]
 ImpairmentsX [list]
 Conditions as main cause of ADLsX
 ADLs helpjX [6]
 IADLs helpkX [9]
 Use of special equipmentlX [8]
 Cognitive functioningX [test]
 Mental healthX [5]
 Treatment relatedm
 Emotional functioningX [5]
 Nagi functioning questionsX [8]
 Special equipment outsideX [3]
 SeeingX
 HearingX [2]
 SpeechX [2]
 Social behaviorsnX [9]
 Housing characteristicsX [10]
HRS—2008
 Nagi functioning questionsX
 General ADLs—difficultyX [6]
 General ADLs—get helpX [6]
 General IADLs—difficultyX [5]
 General IADLs—get helpX [5]
 Conditions
  Cause impairmentX
  ListX
 Mental health (9)X
 Social behavior (3)X
How often
 WorkoX [4]
 Employer-provided accommodationsX[10]
 HearingX [2]
 SeeingX
 Cognition/memorypX [test]
 DrivingqX [5]
Measured at organized activity level
 Use of equipmentr and what typeX [5]
WHAS—1995
Screener
 Nagi functioning questions—any difficultyX [5]
 Nagi functioning questions—how much difficultyX [5]
 General ADLs—any difficultyX [5]
 General ADLs—how much difficultyX [5]
 General IADLs—any difficultyX [5]
 General IADLs—how much difficultyX [5]
 Conditions listX [13]
 Cognitive functioningX [test]
Sampled persons
 Nagi functioning questionsX [8]
  Start date/main condition causeX [8]
  Use of devices for functioning and frequencyX [6]
 General ADLsX [5]
  Do differentlyX [5]
  Get help
  Use of devicesX [5]
 General IADLsX [8]
  Done less often or differently/helpX [8]
 ConditionstX [list]
 Mental healthuX [36]
 Social behavior and frequencyvX [4]
 SeeingX [5]
 HearingX [11]
 Quality of life (20)Intervening concept in IOM model

NOTE: HRS = Health and Retirement Study, IOM = Institute of Medicine, LSOA = Longitudinal Survey of Aging, NLTCS = National Long-Term Care Survey, WHAS = Women’s Health and Aging Study.

a

Basic actions represent deliberate willful functioning of the whole person.

b

Disability as it is described in Nagi as behavior that develops over a period in a situation of long-term impairment associated with functional limitation within the individual’s social and physical environment. The disability is not the functioning, but the behavior that evolves.

c

Reflects functioning in role situation, from maintaining independence to fulfilling expectations as a parent, spouse, employee, etc.

d

Represents the two environmental components of cultural expectations and social and physical environment.

e

Questions about vision and hearing asked about the body part function rather than the functioning of the whole person.

f

Indicators of cognitive functioning based on a series of tests of the person’s cognitive capacity, mainly memory, and orientation.

g

Social behavior questions have the potential to provide insights into behavior changes associated with disability if altered somewhat.

h

Questions about leaving home also provide an opportunity to identify behavior change associated with disability if questions are adapted to capture the necessary information.

i

Provide some environmental information.

j

ADL questions contain a whole series of information about use of help, supervision or standby help, use of assistive devices, how long help was needed, how frequently help was needed.

k

Similar to ADL question in focus on help, assistive device use, and timing.

l

Survey contains a variety of special equipment questions associated with ADL limitations and IADLs. These questions refer to activities inside the house. There is also information on assistive devices related to going outside, vision, and hearing in other locations throughout the survey. These are noted below.

m

There are two questions about hospitalization and doctor use for mental health problems and three questions about the use of medication.

n

Social behaviors if adapted to changes pre- and post-condition, impairment, or functioning onset would reflect disability behavior.

o

Work questions focus on paid work and housework and identify limitations as well as being totally unable. However, a group of additional questions provides information about ability to work full- or part-time; doing the same or different work and the provision of some accessibility by the employer.

p

Provides extensive set of questions to test memory, other areas of cognitive functioning scattered about (ability to follow a map), but emphasis on memory.

q

Very interesting combination of questions to ascertain information about the organized activity of driving, including recent behavior.

r

Asked in conjunction with ADL questions.

s

Limited to women aged 65 and over.

t

Condition list limited to 13 types of conditions, but detailed questions provide much more information about location of impairment or the nature of the symptoms.

u

Extensive set of questions reflecting symptoms associated with depression and anxiety.

v

Questions in other sections about bowling and card games may reflect social behavior, but are asked in terms of symptoms experienced when doing them.

Basic actions represent deliberate willful functioning of the whole person.

Disability as it is described in Nagi as behavior that develops over a period in a situation of long-term impairment associated with functional limitation within the individual’s social and physical environment. The disability is not the functioning, but the behavior that evolves.

Reflects functioning in role situation, from maintaining independence to fulfilling expectations as a parent, spouse, employee, etc.

Represents the two environmental components of cultural expectations and social and physical environment.

Questions about vision and hearing asked about the body part function rather than the functioning of the whole person.

Indicators of cognitive functioning based on a series of tests of the person’s cognitive capacity, mainly memory, and orientation.

Social behavior questions have the potential to provide insights into behavior changes associated with disability if altered somewhat.

Questions about leaving home also provide an opportunity to identify behavior change associated with disability if questions are adapted to capture the necessary information.

Provide some environmental information.

ADL questions contain a whole series of information about use of help, supervision or standby help, use of assistive devices, how long help was needed, how frequently help was needed.

Similar to ADL question in focus on help, assistive device use, and timing.

Survey contains a variety of special equipment questions associated with ADL limitations and IADLs. These questions refer to activities inside the house. There is also information on assistive devices related to going outside, vision, and hearing in other locations throughout the survey. These are noted below.

There are two questions about hospitalization and doctor use for mental health problems and three questions about the use of medication.

Social behaviors if adapted to changes pre- and post-condition, impairment, or functioning onset would reflect disability behavior.

Work questions focus on paid work and housework and identify limitations as well as being totally unable. However, a group of additional questions provides information about ability to work full- or part-time; doing the same or different work and the provision of some accessibility by the employer.

Provides extensive set of questions to test memory, other areas of cognitive functioning scattered about (ability to follow a map), but emphasis on memory.

Very interesting combination of questions to ascertain information about the organized activity of driving, including recent behavior.

Asked in conjunction with ADL questions.

Limited to women aged 65 and over.

Condition list limited to 13 types of conditions, but detailed questions provide much more information about location of impairment or the nature of the symptoms.

Extensive set of questions reflecting symptoms associated with depression and anxiety.

Questions in other sections about bowling and card games may reflect social behavior, but are asked in terms of symptoms experienced when doing them.

From: A, Population Survey Measures of Functioning: Strengths and Weaknesses

Cover of Improving the Measurement of Late-Life Disability in Population Surveys
Improving the Measurement of Late-Life Disability in Population Surveys: Beyond ADLs and IADLs, Summary of a Workshop.
National Research Council (US) Committee on National Statistics; National Research Council (US) Committee on Population.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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