This IADL scale was developed to assess the complex ADLs for older adults living in the community (Lawton & Brody 1969). It assesses a person’s ability to perform tasks such as using a telephone, doing laundry, and handling finances. Each item relies on either cognitive or physical function, though all require some degree of both.

Number of items: 8

Procedure/Administration: The scale can be administered with a written questionnaire or by interview. The patient or a family member or caregiver may provide answers. Responses to each of the eight items in the scale will vary ranging from independence in performing the activity to not performing the activity at all.

How scored: Responses range from 0 (unable or partially able) to 1 (able).  Alternatively, the level of independence can be reflected using a three point scale; 0=unable, 1=needs assistance or 2=independent.

Interpretability: Item responses are summed to derive a scale score with higher scores indicating great independence. 

Acceptability:  Only one study, with findings of weak construct validity has been performed to test the IADL psychometric properties among an SCI population

Languages: English

Usability: It is easy to administer and provides various response options for each item, thereby, enabling flexibility when scoring.

Time to administer: 1 minute

Time to score: N/a

Training required: N/a

Availability: www.abramsoncenter.org/pri/documents/iadl.pdf

Equipment required: N/a

Summary:

• The IADL measures more complex (instrumental) levels of functioning than other ADL instruments. The IADL scale is therefore likely to be more sensitive in detecting earlier, less severe dysfunction.
• The content of IADL measures often reflects specific cultural concerns. For example, British measures frequently include the ability to make a cup of tea. There is also potential for gender bias as the scale may overemphasize tasks customarily performed by women and thus overestimate dependency in men.

Psychometric Summary

Note: TR= Test re-test; IC= Internal Consistency; Inter-O=Inter-observer; Intra-O=Intra-observer; SS=Sensitivity/Specificity; N/a= No information.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

References

• Lawton G, Lundgren-Nilsson A, Biering-Sorensen F, Tesio L, Slade A, Penta M, Grimby G, Ring H, Tennant A. Cross-cultural validity of FIM in spinal cord injury. Spinal Cord 2006; 44: 746-752.