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J Rehabil Med. 2004 Sep;36(5):226-31.

Assessing disability in older adults: the effects of asking questions with and without health attribution.

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  • 1Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA.



To determine the effects of using questions with and without health attribution on scores derived from a self-report disability instrument.


We administered the disability component of the Late Life Function and Disability Instrument to 75 community-dwelling older adults. Then, we administered the same 16 questions with attribution to specific health conditions. We used a series of analytic methods including weighted Kappa coefficient, Bowker's Test of Symmetry and Rasch analysis to assess the effects of attribution formats.


A higher prevalence of disability was reported in the non-health attributed compared with the health attributed questions (t = 5.76; p < 0.001, 95% CI 3.8-7.8). Item analyses indicated that participants were significantly more likely to report disability on the non-health attributed version on 4 of the 16 questions.


For community-dwelling older adults, the use of a non-health attribution format may be preferable in instruments designed to assess prevalence of disability from contributing factors other than just health.

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