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Identifying longitudinal sustainable hierarchies in activities of daily living

Watson, Roger; Palese, Alvisa; Zuttion, Ranieri; Ferrario, Barbara; Ponta, Sandra; Hayter, Mark


Alvisa Palese

Ranieri Zuttion

Barbara Ferrario

Sandra Ponta

Mark Hayter


© 2017 Elsevier B.V. Activities of daily living serve as an indicator of progression in disability and rehabilitation. It is know that some of the measurement scales used show hierarchical properties indicating that activities of daily living are lost and gained in a consistent pattern. Few studies have investigated the extent to which these patterns are sustained across time and across a range of disability. The study aimed to investigate the hierarchical properties of the activity of daily living items in the ValGraf functional ability scale, to establish if there is a hierarchy of items in the scale and to study the sustainability of the hierarchy over time. Secondary analysis of a retrospective database from 13,113 people over 65 years in 105 nursing homes in northern Italy, between 2008 and 2013 was conducted. Data were gathered 6-monthly and analysed using Mokken scaling to identify a hierarchy of items in the scale and if this was sustainable over time. A sustainable hierarchy of items was observed running in difficulty from urinary incontinence to feeding. The hierarchical structure of the activities of daily living observed in the present study is stable over time meaning that changes in total score for these items can be compared meaningfully across time.


Watson, R., Palese, A., Zuttion, R., Ferrario, B., Ponta, S., & Hayter, M. (2017). Identifying longitudinal sustainable hierarchies in activities of daily living. Archives of Gerontology and Geriatrics, 71, 122-128.

Journal Article Type Article
Acceptance Date Apr 4, 2017
Online Publication Date Apr 12, 2017
Publication Date 2017-07
Deposit Date May 23, 2017
Publicly Available Date Apr 17, 2018
Journal Archives of gerontology and geriatrics
Electronic ISSN 1872-6976
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 71
Pages 122-128
Keywords Mokken scaling; Activities of daily living; Nursing homes; ValGraf instrument
Public URL
Publisher URL
Additional Information This is the accepted manuscript of an article published in Archives of gerontology and geriatrics, 2017. The version of record is available at the DOI link in this record.


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