Cultural diversity and the measurement of functional impairment: A cross-cultural validation of the Amsterdam IADL Questionnaire
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INTRODUCTION: Assessment of cognitively complex instrumental activities of daily living (IADL) is important in (incipient) dementia, but little is known about the influence of cultural differences. We aim to investigate the cross-cultural comparability of IADL. METHODS: IADL were measured in 3,571 individuals (67.1 +- 9.5 years old, 44.7 using the Amsterdam IADL Questionnaire (A-IADL-Q). Cultural, age and gender bias were assessed on item level using differential item functioning (DIF) and on scale level by calculating correlations between IADL and cognitive and functional measures. RESULTS: We did not find meaningful bias on item or on scale level, as indicated by low DIF effect sizes (R2 range 0-0.03) and correlations in expected directions and of similar magnitude. DISCUSSION: Our results suggest that IADL may be universally suitable as outcome measure. The A-IADL-Q seems robust to demographic diversity and is capable of reliably measuring IADL impairment.
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