Enhancing 'meaningfulness' of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Int Psychogeriatr. 2021 Jan;33(1):39-50. doi: 10.1017/S1041610219001881. Epub 2020 Apr 15.


Objective: Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version.

Design: An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment.

Setting: Community settings in the UK.

Participants: One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer's disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI.

Measurements: The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures.

Results: Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score (Kendall's Tau -.388, -.445, -.497, -.569). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures.

Conclusion: The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.

Keywords: Amsterdam IADL Questionnaire (A-IADL-Q); Instrumental activities of daily living (IADL); cross-cultural adaptation; mild cognitive impairment (MCI); subjective cognitive decline (SCD).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Alzheimer Disease* / diagnosis
  • Cognitive Dysfunction* / diagnosis
  • Female
  • Humans
  • Neuropsychological Tests
  • Surveys and Questionnaires
  • United Kingdom