Self-reported function and disability in late life – cross-cultural adaptation and validation of the Swedish version of the late-life function and disability instrument

Abstract

Purpose: To translate and perform a cross-cultural adaptation of the Late-Life Function and Disability Instrument (LLFDI) to Swedish, to investigate absolute and relative reliability, concurrent validity, and floor and ceiling effects within a Swedish-speaking sample of community-dwelling older adults with self-reported balance deficits and fear of falling. Method: Translation, reliability and validation study of the LLFDI. Sixty-two community-dwelling, healthy older adults (54 women and 8 men) aged 68–88 years with balance deficits and fear of falling performed the LLFDI twice with an interval of 2 weeks. Results: Test–retest agreement, intra-class correlation coefficient was very good, 0.87–0.91 in the LLFDI function component and 0.82–0.91 in the LLFDI disability component. The standard error of measure was small, 5–9%, and the smallest real difference was 14–24%. Internal consistency (Cronbach’s alpha) was high (0.90–0.96). Correlation with the SF-36 PCS and PF-10 was moderate in both LLFDI function, r = 0.39–0.68 and r = 0.35–0.52, and LLFDI disability, r = 0.40–0.63 and 0.34–0.57, respectively. There was no floor or ceiling effects. Conclusion: The Swedish version of the LLFDI is a highly reliable and valid instrument for assessing function and disability in community-dwelling older women with self-reported balance deficits and fear of falling.

Implications for Rehabilitation

• The Swedish LLFDI is a highly reliable and valid instrument for assessing function and disability in older women with self-reported balance deficits and fear of falling.

• The instrument may be used both in clinical settings and in research.

• The instrument is sensitive to change and a reasonably small improvement is enough to detect changes in a group or a single individual.

• Elderly
• fear of falling
• LLFDI
• reliability
• Swedish
• validity

Acknowledgements

The authors would like to thank all the participants in the study. A special thanks to Elisabeth Olsson at Karolinska Institutet for conceptualization of the study and participation in the expert panel, to Alan Jette at Boston University for kind permission to translate the questionnaire, to Lars Oddsson at Sister Kenny Research Center for participating in the translation process, to Anna Petterson and Elin Farén and expert panels at Karolinska University Hospital for participation in the cross-cultural adaptation, and to Lisbet Boman at Karolinska Institutet for help and guidance in data collection and statistical calculations.