Talk the talk and walk the walk. Evaluation of autonomy in aging and Alzheimer Disease by simulating instrumental activities of daily living: The S-IADL

The autonomy of individuals is linked to the achievement of instrumental activities of daily living that require complex behavior. In elderly, the assessment of autonomy is usually based on questionnaires that have strong subjective constraints. Considering this fact, we tested on elderly healthy adults and Alzheimer disease patients, a new measure, the S-IADL (Simulation of Instrumental Activities for Daily Living) to assess the ability to perform effectively activities of daily living. The S-IADL shares many items with the well-known IADL questionnaire proposed by Lawton and Brody (1969). However, as opposed to the IADL, the assessment of autonomy is not based on the completion of a questionnaire but requires the realization or simulation of various activities of daily living. Eighty-three participants (69 healthy elderly, and 14 Alzheimer Disease patients) filled in the IADL and performed the S-IADL assessment. Results revealed that like the IADL, the S-IADL is able to identify AD patients who are likely to encounter difficulties in performing everyday activities, and no major differences were found between the IADL and the S-IADL. However, this preliminary study reveals some advantages for privileging new tool based on simulation of activities in functional evaluation particularly in specific situation. Finally, we discuss of the main limits of the S-IADL that should be investigated prior to its utilization by clinicians.