Tools for the evaluation of daily life activities instrumental in adults: systematic review

Background: The transition to the biopsychosocial model implies that the assessment tools are adapted to this new vision of health. In Chile, the evaluations to measure functionality on Instrumental Activities of Daily Living (IADL), have been the same since the 1950s, so a review of the literature is required to know new evaluation tools in the matter. Aim: To identify the evaluation tools that exist to assess the functionality in AVDI, what items are considered, scoring methodology (rank, score, categorization of results), time and in which contexts they are applied, assessment creators and psychometric properties. Design: Systematic review. Data sources: PubMed, BIREME and Epistemonikos. Three searches were carried out: two in 2018 (March and September) and one in 2020 (December). Study selection: Observational studies (cohort studies and cross-sectional studies) and Systematic Reviews that contemplated the assessment of IADL in people over 18 years of age, in English or Spanish, published since 1998 and open access. Data extraction: Titles and abstracts were read as a first filter, followed by the full text. Once the studies that met the inclusion criteria had been selected, the “Strengthening The Reporting of Observational studies in Epidemiology (STROBE)” and “Critical Appraisal Skills Programme Spanish (CASPe)” guideline was applied to assess methodological quality. It was established, through a consensus of the researchers, that each selected study had to comply with at least 13 of the 22 items of STROBE guideline. Results: Of the 27.606 articles found, 15 met the inclusion criteria and the established cut-off point of the guideline. One article was written in Spanish and 14 in English, which were carried out mainly in the United States and Spain (3 out of 15 respectively). Of the 20 instruments found in the selected articles, 60% correspond to “Lawton & Brody Scale”, 10% to “The Performance Assessment of Self-Care Skills (PASS)” and the remaining percentage other tools. Conclusions: At an international level, new IADL assessment tools have been created in response to local needs, making it difficult to generalize to other contexts without previously having a cross-cultural and statistical validation process that safeguards the reliability of its application and data. The “Lawton s Brody Scale”, despite its limitations and biases, remains an international gold standard.