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Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test

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Background. Adequate and user-friendly instruments for assessing physical function and
disability in older adults are vital for estimating and predicting health care needs in clinical
practice. The Late-Life Function and Disability Instrument Computer Adaptive Test (LLFDICAT)
is a promising instrument for assessing physical function and disability in gerontology
research and clinical practice.
Objective. The aims of this study were: (1) to translate the LLFDI-CAT to the Dutch
language and (2) to investigate its validity and reliability in a sample of older adults who spoke
Dutch and dwelled in the community.
Design. For the assessment of validity of the LLFDI-CAT, a cross-sectional design was used.
To assess reliability, measurement of the LLFDI-CAT was repeated in the same sample.
Methods. The item bank of the LLFDI-CAT was translated with a forward-backward
procedure. A sample of 54 older adults completed the LLFDI-CAT, World Health Organization
Disability Assessment Schedule 2.0, RAND 36-Item Short-Form Health Survey physical functioning
scale (10 items), and 10-Meter Walk Test. The LLFDI-CAT was repeated in 2 to 8 days
(mean4.5 days). Pearson’s r and the intraclass correlation coefficient (ICC) (2,1) were
calculated to assess validity, group-level reliability, and participant-level reliability.
Results. A correlation of .74 for the LLFDI-CAT function scale and the RAND 36-Item
Short-Form Health Survey physical functioning scale (10 items) was found. The correlations of
the LLFDI-CAT disability scale with the World Health Organization Disability Assessment
Schedule 2.0 and the 10-Meter Walk Test were .57 and .53, respectively. The ICC (2,1) of
the LLFDI-CAT function scale was .84, with a group-level reliability score of .85. The ICC (2,1)
of the LLFDI-CAT disability scale was .76, with a group-level reliability score of .81.
Limitations. The high percentage of women in the study and the exclusion of older adults
with recent joint replacement or hospitalization limit the generalizability of the results.
Conclusions. The Dutch LLFDI-CAT showed strong validity and high reliability when used
to assess physical function and disability in older adults dwelling in the community.


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