FACTORS RELATED TO SELF-RATED HEALTH IN OLDER ADULTS: A CLINICAL APPROACH USING THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (ICF) MODEL

Review written by Dr Mariana Wingood info

BACKGROUND & OBJECTIVE

Finding assessment tools that are informative and efficient can be challenging, particularly when trying to capture a unique construct such as health. One commonly used tool is the Self-Rated Health (SRH) question - “Would you say your health is excellent, very good, good, fair, or poor?” (1,2). However, this general question may not be sensitive enough to identify an older adult’s function. Therefore, a more comprehensive assessment is recommended.

This can be done using a standardized framework such as the International Classification of Functioning, Disability, and Health (ICF) (3). The ICF is divided into the following components to describe an individual’s health and health-related diagnosis: body function (physiological function of body systems), body structure (anatomical parts of the body), activity (execution of task), participation (involvement in a life situation), environmental (physical, social, and attitudinal), and personal (individual factors that affect the experience of the health condition) (4). The primary aim of this paper was to examine the associations between SRH and variables representing the ICF domains that may be associated with function in community-dwelling older adults.

METHODS

Participants: Community-dwelling older adults who could walk 20 feet without assistance or an assistive device. Participants were excluded if they had knee surgery within the past 6 months, indicated a pain score of 6 or greater on the numeric pain rating scale, or had a cognitive impairment. Data Collection: Participants completed a sociodemographic questionnaire, self-rated health (health rated on a 5-point scale: 1=poor to 5=excellent), Activities-Specific Balance Confidence-6 (ABC-6 – a 6-item scale rating confidence with balance activity from 0%=not confident to 100%=completely confident), Keele Assessment of Participation (KAP – 11-item scale rating participation levels: 5=all of the time to 1=none of the time), and Neighborhood Environment Walkability Scale Abbreviation (NEWS-A – a 54-item scale rating the walkability of a neighborhood with 1=strongly disagree and 4=strongly agree). The researchers also measured the participants’ Body Mass Index (BMI), spatiotemporal gait parameters, and knee extensor strength.

RESULTS

The authors used a Spearman ρ, a statistical method of examining the association between two variables, to identify what ICF variables were associated with SRH. The correlation can range between -1 to 1, with -1 indicating a perfect negative association

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