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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.
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.
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.