Validation of the Late-Life Function and Disability Instrument in People Living with Chronic Obstructive Pulmonary Disease: A Clinical Trial

<b>Rationale:</b> Disability and loss of function are acknowledged as important problems for people living with chronic obstructive pulmonary disease (COPD), but there is a need for validated tools to assess them. <b>Objectives:</b> The Late-Life Function and Disability Instrument (LLFDI) was originally validated for community-dwelling older adults. The full instrument has not been validated to assess disability and loss of function in people with COPD. <b>Methods:</b> People with COPD from six European countries completed the LLFDI as part of an observational study. Its validity was assessed in terms of <i>1</i>) levels and distribution of LLFDI domain and subdomain scores; <i>2</i>) floor and ceiling effects; <i>3</i>) instrument structure (three domains, seven subdomains) by confirmatory factor analysis; and <i>4</i>) construct validity by convergent validity, which is based on Spearman correlation with COPD-relevant and related constructs (functional exercise capacity, severity of dyspnea, and COPD-related health status), and known-groups validity, which is based on the distribution of LLFDI scores according to COPD-meaningful groups (disease severity, age groups, and use of a walking aid). <b>Results:</b> The study included 605 participants (ages 68 ± 8 yr, 37% female; FEV<sub>1</sub> = 54 ± 20 % predicted). Most had impaired disability and function levels. We observed no floor effects and a ceiling effect in only two subdomains. Confirmatory factor analysis showed a moderate model fit for all LLFDI domains. Most of the correlations met our hypotheses (73%), with moderate to strong correlations for the function domain (<i>r</i><sub>min-max</sub> = 0.25-0.70), followed by the disability limitation domain (<i>r</i><sub>min-max</sub> = 0.15-0.54), and weakest correlations in the disability frequency domain (<i>r</i><sub>min-max</sub> = 0.04-0.41). The disability limitation and function domains differed by disease severity, age group, and use of a walking aid. The disability frequency domain differed by disease severity and use of a walking aid, but not by age groups. <b>Conclusions:</b> The LLFDI, a valid patient-reported outcome to investigate disability and function, has proven good construct validity in people with COPD. Clinical trial registered with the ISRCTN registry (ISRCTN no. 12051706); https://www.isrctn.com/ISRCTN12051706.

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Publication Details

Journal
Annals of the American Thoracic Society
Published
2024-09-23
DOI
https://doi.org/10.1513/annalsats.202404-432oc
Citations
1
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
Field-Weighted Citation Impact
0.42

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article

Validation of the Late-Life Function and Disability Instrument in People Living with Chronic Obstructive Pulmonary Disease: A Clinical Trial

Emily Hume, Nicholas S Hopkinson, Dimitrios Megaritis, Thierry Troosters et al.
1 citations
Annals of the American Thoracic Society
Chronic Obstructive Pulmonary Disease (COPD) Research
0.42
article

Validation of the Late-Life Function and Disability Instrument in People Living with Chronic Obstructive Pulmonary Disease: A Clinical Trial

Emily Hume, Nicholas S Hopkinson, Dimitrios Megaritis, Thierry Troosters, Astrid Blondeel, Lies Glorie, Nikolaos Chynkiamis, Joren Buekers, Judith García‐Aymerich, Anne‐Marie Kirsten, Anja Frei, Sara Buttery, Laura Delgado‐Ortiz, Marieke Wuyts, Lynn Rochester, Sarah Koch, Milo A. Puhan, Heleen Demeyer, Elena Gimeno‐Santos, Henrik Watz, Carl-Philipp Jansen, Victoria Alcaraz-Serrano, Alícia Josa-Culleré, I. I. Vogiatzis, Paulien Mellaerts
article en
1 citations

Abstract

<b>Rationale:</b> Disability and loss of function are acknowledged as important problems for people living with chronic obstructive pulmonary disease (COPD), but there is a need for validated tools to assess them. <b>Objectives:</b> The Late-Life Function and Disability Instrument (LLFDI) was originally validated for community-dwelling older adults. The full instrument has not been validated to assess disability and loss of function in people with COPD. <b>Methods:</b> People with COPD from six European countries completed the LLFDI as part of an observational study. Its validity was assessed in terms of <i>1</i>) levels and distribution of LLFDI domain and subdomain scores; <i>2</i>) floor and ceiling effects; <i>3</i>) instrument structure (three domains, seven subdomains) by confirmatory factor analysis; and <i>4</i>) construct validity by convergent validity, which is based on Spearman correlation with COPD-relevant and related constructs (functional exercise capacity, severity of dyspnea, and COPD-related health status), and known-groups validity, which is based on the distribution of LLFDI scores according to COPD-meaningful groups (disease severity, age groups, and use of a walking aid). <b>Results:</b> The study included 605 participants (ages 68 ± 8 yr, 37% female; FEV<sub>1</sub> = 54 ± 20 % predicted). Most had impaired disability and function levels. We observed no floor effects and a ceiling effect in only two subdomains. Confirmatory factor analysis showed a moderate model fit for all LLFDI domains. Most of the correlations met our hypotheses (73%), with moderate to strong correlations for the function domain (<i>r</i><sub>min-max</sub> = 0.25-0.70), followed by the disability limitation domain (<i>r</i><sub>min-max</sub> = 0.15-0.54), and weakest correlations in the disability frequency domain (<i>r</i><sub>min-max</sub> = 0.04-0.41). The disability limitation and function domains differed by disease severity, age group, and use of a walking aid. The disability frequency domain differed by disease severity and use of a walking aid, but not by age groups. <b>Conclusions:</b> The LLFDI, a valid patient-reported outcome to investigate disability and function, has proven good construct validity in people with COPD. Clinical trial registered with the ISRCTN registry (ISRCTN no. 12051706); https://www.isrctn.com/ISRCTN12051706.

Annals of the American Thoracic SocietyVol. 22(1)
Universitat Pompeu Fabra (ES), National and Kapodistrian University of Athens (GR), University of Zurich (CH), Heidelberg University (DE), Ghent University Hospital (BE), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), University Hospital Heidelberg (DE), Robert Bosch Hospital (DE), Northumbria University (GB), National Institute for Health and Care Excellence (GB), German Center for Lung Research (DE), LungenClinic Grosshansdorf (DE), Barcelona Institute for Global Health (ES), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Thorax Foundation (GR), Sotiria General Hospital (GR), Imperial College London (GB), Universitat Ramon Llull (ES), Newcastle University (GB), Heidelberg University (US), KU Leuven (BE)
European Federation of Pharmaceutical Industries and Associations, Ministerio de Ciencia, Innovación y Universidades, Centres de Recerca de Catalunya, Parkinson's UK, European Commission, Generalitat de Catalunya, Medical Research Council, Engineering and Physical Sciences Research Council, Instituto de Salud Carlos III, NIHR Newcastle Biomedical Research Centre
Reduced inequalities
Openalex Percentile: Top 33%
Chronic Obstructive Pulmonary Disease (COPD) Research
0.42
DOIOpen Access PDFOpenAlex
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