File
Garcia I.1, Lunardi A.1,2, Tiuganji C.1, Simões M.S.2, Lopes I.3
1Universidade Cidade de São Paulo, São Paulo, Brazil, 2Universidade de São Paulo, São Paulo, Brazil, 3Universidade Federal de São Paulo, São Paulo, Brazil
Background: The disease and systemic consequences related to COPD, as dyspnea and sarcopenia, impair the performance capacity of activities of daily living and the level of daily physical activity, especially in older adults. The performance of activities of daily living and the level of daily physical activity in individuals with COPD can be assessed by questionnaires. However, the safe use of a questionnaire should be preceded by the investigation of its measurement properties, since instruments are applied to specific populations. The University of Alabama at Birmingham Study of Aging Life-space Assessment questionnaire assesses the frequency and independence that older adults move inside and outside their home. This questionnaire has been applied in the assessment of life-space mobility of older adults with kidney disease, fecal incontinence and stroke, but it has never been validated for older adults with COPD.
Purpose: To test the measurement properties (reliability, construct validity and interpretability) of the The University of Alabama at Birmingham Study of Aging Life-Space Assessment questionnaire for older adults with COPD.
Methods: This clinimetric study involved 62 older adults with COPD (aged 77±4 years old; FEV1=59±12% predict; BMI=27±5 Kg/m2; GOLD I: 3; GOLD II: 37; GOLD III: 17; GOLD IV: 5). Initially, the questionnaire was administered (test) and the accelerometry was started. Accelerometer (ActiGraph GT3X) was put on participants waist and data were collected for 7 consecutive days. After that period, the questionnaire was re-administered (retest) and the accelerometer was removed. Reliability was analyzed by the Cronbach´s alpha (internal consistency), intraclass correlation coefficients (ICC2,1) and 95% confidence interval (95%CI) (reproducibility), and standard error of measurement (SEM) (measurement error). The construct validity was analyzed by Pearsons correlation between the scores of LSA and accelerometry data (steps count and time in moderate activities). Interpretability was analyzed by minimal detectable change with 90% confidence (MDC90), and determination of floor and ceiling effects by calculating the proportion of participants who achieved the minimum or maximum scores. and ceiling and floor effects. The level of significance for all tests was set at 5%.
Results: Internal consistency (Cronbachs alpha) was 0.80 (range= 0.76 to 0.80), and reproducibility (ICC2,1) was 0.90 (95%CI 0.84 to 0.94). SEM was calculated in 3.65 points (3%). We observed an association between the score of the questionnaire and steps count (r= 0.43; p= 0.01) and time spent in moderate activities (r= 0.42; p= 0.01). The MDC90 was 0.20 points. Ceiling (2%) or floor effects (6%) were not observed.
Conclusion(s): The Life-Space Assessment questionnaire showed adequate reliability, validity and interpretability for the assessment of life-space mobility among older adults with COPD. The score to consider as a change in life-space mobility for this population was calculated in 3.85 points.
Implications: We see an increasing need for evaluation of functionality of subjects with COPD, and a lack of validated instruments for use in this population. Therefore, the Life-Space Assessment, now validated for use in older adults with COPD, can contribute positively in clinical and research settings, allowing practitioners to perform mobility assessment of this population.
Funding acknowledgements: This study received no funding
Topic: Older people
Ethics approval: Ethics Committee of the University City of São Paulo (CAAE: 29380314.0.0000.0064) and the Ethics Committee of Mandaqui Hospital (CAAE: 29380314.0.3001.5551).
All authors, affiliations and abstracts have been published as submitted.
