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ADL Smartcare Accessiblity Help

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Font Size

You can increase or reduce the size of the text by clicking the up or down buttons on the toolbar at the top of the ADL Smartcare website. The text can be increased by up to 3x its original size.

Choose a different typeface

Font Choice

Click this button to change to a different typeface. There is a choice between serif, sans-serif and comic sans fonts.

Change the colours of the website


The ADL Smartcare Limited website has a variety of different themes to choose from including a high-contrast colour scheme. You can also view the website in a text-only format.

Reading ruler option

Reading Ruler

The reading ruler is to assist you with reading the website. The ruler will follow the movements of your mouse cursor, covering the space above and below to make it easier to read one line at a time.

The dictionary tool


If you double click on a word, you will be able to view its definition from the Macmillan Dictionary. When you double-click on a word, a window opens which lists the different ways a word is used. Pick the most suitable usage and you will be able to read its definition.

If you want to look up words not on this website, you can do this at Macmillan Dictionaries Online.

You also have the option to view the website in a different language. Click on the "Select a language" box and pick a language from the list displayed.

Screen reader

Screen Reader

For blind and visually impaired users we recommend NVDA (NonVisual Desktop Access), a free "screen reader" application which reads the text on the screen in a computerised voice. This tool can be used on a variety of different programmes on your computer - not just your web browser or the Smartcare website.

You can control what is read to you by moving the cursor to the relevant area of text with a mouse or the arrows on your keyboard.

Click on the screen reader icon on the tool bar for more information and a link to download the programme on to your computer.

ADL LifeCurve™ logo

The ADL LifeCurve™ is a tool developed by ADL Research and Newcastle University's Institute for Ageing which may be used to map age related functional decline. It provides a framework understanding the most appropriate stage to intervene and which interventions are most effective.

LifeCurve graph

Development of ADL LifeCurve

Research and development of the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) are important in understanding the tasks, constraints and solutions to help older adults live better for longer, which is an integral part of ADL Research.

To push the boundaries further in our understanding of functional difficulties in older adults we searched for answers that would better aid in our understanding, but also facilitate a better understand of activities, services and products to help older adults. This was derived from research carried out in Newcastle University which identified a hierarchical order to the loss of function.

Access to Insight:

Early evidence of a hierarchy of functional ability was published in 1963 by Sidney Katz (Katz et al, 1963), showing that 6 ADL tasks (bathing, dressing, going to the toilet, transferring, continence, feeding) became impossible in a significant hierarchical order.

Since then, other researchers have further explored this loss - in particular (Kempen, et al., 1995), (Dunlop, et al., 1997), (Ferrucci, et al., 1998), (Njegovan, et al., 2001), (Jagger, et al., 2001) and (Weiss, et al., 2006).

A recent study published in 2012 led the way for the development of the ADL LifeCurve™, entitled "Losing the Ability in Activities of Daily Living in the Oldest Old: A Hierarchic Disability Scale from the Newcastle 85+ Study" (Kingston, et al., 2012). The research was a part of Newcastle University’s 85+ Study which followed a cohort of people aged 85 for a number of years. The study collected data on ADL status, health assessments and mental health. Using appropriate statistical techniques, the study found that a person’s ADL status accounted for most of the prediction of the onset of ADL difficulties. The study then went further to test whether there was a hierarchy to the loss of activities. Using appropriate statistical tests, the research identified, with a high standard of evidence, the existence of an order of onset of difficulty with ADL.

ADL Research then collaborated with researchers in Newcastle University’s Institute for Ageing to allow the translation of research for public knowledge and understanding of the order of loss of activities. This has been the foundation of the ADL LifeCurve™.


Dunlop, D. D., Hughes, S. L. & Manheim, L. M., 1997. Disability in activities of daily living: patterns of change and a hierarchy of disability. American Journal of Public Health, 3(378-383), p. 87.

Ferrucci, L. et al., 1998. Constant Hierarchic Patterns of Physical Functioning Across Seven Populations in Five Countries. The Gerontologist, 38(3), pp. 286-294.

Jagger, C., Arthur, A. J., Spiers, N. A. & Clarke, M., 2001. Patterns of Onset of Disability in Activities of Daily Living with Age. Journal of the American Geriatrics Society, 49(4), pp. 404-409.

Katz, Sidney, et al. 1963. Studies of Illness in the Aged. The Index of ADL: Standardized Measures of Biological and Psychosocial Function. Journal of the American Medical Association. 185 pp. 94 – 101.

Kempen, G., Myers, A. & Powell, L., 1995. Hierarchical structure in ADL and IADL: Analytical assumptions and applications for clinicians and researchers. Journal of Clinical Epidemiology, 48(11), pp. 1299-1305.

Kingston, A. et al., 2012. Losing the Ability in Activities of Daily Living in the Oldest Old: A Hierarchic Disability Scale from the Newcastle 85+ Study. PLoS One, 7(2), p. e31665.

Njegovan, V., Man-Son-Hing, M., Mitchell, S. L. & Molnar, F. J., 2001. The Hierarchy of Functional Loss Associated With Cognitive Decline in Older Persons. The Journals of Gerontology, 56A(10), pp. M638-M643.

Weiss, C. O., Fried, L. P. & Bandeen-Roche, K., 2006. Exploring the Hierarchy of Mobility Performance in High-Functioning Older Women. The Journals of Gerontology, 62A(2), pp. 167-173.