Development and validation of a self-reported scale for difficulty in activities of daily living among older adults

Briede-Westermeyer J.C.; Perez-Villalobos C.; Dinamarca-Montecinos J.L.; Schilling-Norman, MJ.; Sanders, ENB; Luzardo-Briceno M.

Keywords: chile, older adults, psychometrics, user-centered design, Co-design, Activities of daily living (ADL), Perceived difficulty, Spanish-language scale

Abstract

Population aging demands tools that capture not only observed dependence but also perceived difficulty, an area where validated Spanish-language instruments remain scarce. To develop and psychometrically validate the Difficulty Scale for Activities of Daily Living (EDAAD), a self-administered, Spanish-language instrument that measures perceived difficulty across basic, instrumental, and advanced ADLs in community-dwelling older adults. We conducted a cross-sectional study in the Biobío Region (Chile) using multi-stage, stratified random sampling at the commune–block–household levels. Trained interviewers administered face-to-face surveys between October 2022 and February 2023. Independence was screened with the Chilean EFAM-A scale, including only participants scoring ≥ 43 points. The final sample comprised 201 independent older adults aged 60–99 years. Confirmatory factor analysis (CFA; WLSMV estimator) tested an 8-factor structure. Reliability was assessed with Cronbach’s α and McDonald’s ω. Known-groups validity examined associations between EDAAD scores and sociodemographic variables. CFA supported an 8-factor model with acceptable fit for key indices (CFI = 0.905; TLI = 0.891; RMSEA = 0.149; SRMR = 0.103). Internal consistency was excellent for the total scale (α = 0.954; ω = 0.962). Higher perceived difficulty was associated with female gender, older age, lower education, and lower income. Among domains, technology use (M = 3.71) and hobbies (M = 3.43) were the most difficult; personal care (M = 1.96) and mobility (M = 2.70) were the least difficult. EDAAD is, to our knowledge, one of the first self-administered, Spanish-language instruments validated in a Latin American community sample that focuses on perceived difficulty across ADLs. It complements performance-based and dependence measures, enables classification of activities by difficulty level, and can inform user-centered and inclusive interventions to support healthy aging. © The Author(s) 2025.

Más información

Título según WOS: Development and validation of a self-reported scale for difficulty in activities of daily living among older adults
Título de la Revista: Scientific Reports
Volumen: 15
Número: 1
Editorial: Nature Research
Fecha de publicación: 2025
Idioma: English
DOI:

10.1038/s41598-025-21426-3

Notas: ISI