Increasing attention has been paid to the ‘voice’ of people living with mild cognitive impairment (or dementia, but there is a lack of clarity about how everyday life is perceived from this insiderinsider’s perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MC I and dementia living at home.
ObjectiveTo estimate the minimal important change (MIC) and the minimal detectable change (MDC) of the Katz-activities of daily living (ADL) index score and the Lawton instrumental activities of daily living (IADL) scale.DesignData from a cluster-randomized clinical trial and a cohort study.SettingGeneral practices in the Netherlands.Participants3184 trial participants and 51 participants of the cohort study with a mean age of 80.1 (SD 6.4) years.MeasurementsAt baseline and after 6 months, the Katz-ADL index score (0-6 points), the Lawton IADL scale (0-7 points), and self-perceived decline in (I)ADL were assessed using a self-reporting questionnaire. MIC was assessed using anchor-based methods: the (relative) mean change score; and using distributional methods: the effect size (ES), the standard error of measurement (SEM), and 0.5 SD. The MDC was estimated using SEM, based on a test-retest study (2-week interval) and on the anchor-based method.ResultsAnchor-based MICs of the Katz-ADL index score were 0.47 points, while distributional MICs ranged from 0.18 to 0.47 points. Similarly, anchor-based MICs of the Lawton IADL scale were between 0.31 and 0.54 points and distributional MICs ranged from 0.31 to 0.77 points. The MDC varies by sample size. For the MIC to exceed the MDC at least 482 patients are needed.ConclusionThe MIC of both the Katz-ADL index and the Lawton IADL scale lie around half a point. The certainty of this conclusion is reduced by the variation across calculational methods.
Deze publicatie is ontwikkeld door het lectoraat Communicatie, Participatie en Sociaal-Ecologisch Leren (CoPSEL) in samenwerking met partneruniversiteiten als een eindresultaat van het Invest4Excellence project. Het magazine onderzoekt de complexiteit en dynamiek van Living Labs door met een drietal metaforen (koken, reizen en Do-It-Yourself) te reflecteren op Living Labs zowel in Nederland, Europa en daarbuiten.
MULTIFILE
In my PD research, I want to focus on how collectivity is practiced in the arts, by learning from the Indonesian multidisciplinary art collective ruangrupa’s use of [the international art exhibition] ‘documenta’ as a tool, and the potential of continuing the experiences outside this group and context. The art practices programmed by ruangrupa can be understood as complex and ambiguous where art is not at the center of attention but part of a larger communal productivity. And where it is not sufficient to be merely critical, and merely voice opposition, but to engage, and create alternatives in everyday life [without being problem-solving or social design]. My research concerns the potential of continuing these practices and experiences outside this particular artist group and exhibition context. Ruangrupa’s work reveals problems of the current Western art system, how it is (hierarchically) organized, the implicit rules, norms and values it is based on. Ruangrupa's practice thus serves as an exercise and point of departure to answer questions about forms of self-organization within the art field. Its collective and multidisciplinary art practice implies the question whether it also can serve as a model for living together on a larger scale (also outside the arts), beyond hierarchies of social and professional structures. There is currently a lack of research on these particular art practices, so that they are not easily accessible for non-participants. For the art field in particular, this concerns the question whether contemporary art can and needs to take place outside established Western gallery/museum, art/curatorial paradigms and what can be learned from ruangrupa's and documenta fifteen's blending of art practice with daily life practice. This is also an urgent practical issue for art schools (including my school Willem de Kooning Academy) that increasingly develop art study programs outside the studio and gallery art paradigm.