Geriatric Research Instrument Library (GRIL)
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The Geriatric Research Instrument Library (GRIL) is a web-based repository of information and resources about measurement instruments commonly used in gerontological research. Researchers can use GRIL to identify, compare and select instruments for their research investigations. A brief description of each instrument and a link to its relevant manuscript are provided. Begin your search by navigating through the instrument domains listed to the left or by using the search bar.
The development of GRIL has been supported by the Claude D. Pepper Older Americans Independence Centers (OAICs) at Yale University, Duke University and Wake Forest University. Development of the content was originally supported by National Institute on Aging grant 2P30 AG021342-06S1 to Yale University.
GRIL is currently supported by National Institute on Aging grant numbers U24AG05964 for the OAIC Coordinating Center and R33 AG045050 for the HCSRN (Health Care Systems Research Network)-OAICs AGING (Advancing Geriatrics Research Infrastructure and Network Growth) Initiative.
Note: Copyright issues may require a fee to utilize certain instruments.
Anxiety Instruments: Home
- Beck Anxiety Inventory (BAI)
Developed to differentiate between anxiety and depression. It can be filled out by the respondent or interviewer. The 21 item scale has 14 items that are somatic and 7 items that reflect anxiety and panic. Each item scores the severity as 0 (not at all) to 3 (severely). Common cut-points are 0-9 = normal; 10-18 = mild/moderate anxiety; 19-29 = moderate anxiety, and 30-63 = severe anxiety.
- Generalized Anxiety Disorder 7-Item Scale (GAD7)
A self-reported anxiety scale based on DSM diagnostic criteria. The severity of each symptom is rated from 0 (Not at all) to 3 (nearly every day) for the past two weeks. The GAD-7 has seven items with a total score of 0-21. Common cut-points are: 0-4 (minimal anxiety), 5-9 (mild anxiety), 10-14 (moderate anxiety), and 15+ (severe anxiety).
- Symptom Checklist 90-R (SCL-90-R)
A 90-item self-report symptom inventory to measure psychological current symptom patterns of respondents in different settings (e.g. community, medical, psychiatric)
Delirium Instruments: Home
- Confusion Assessment Method (CAM)
Developed for nonpsychiatric clinicians to assess delirium. This version is based on an interview with the patient and measures the same dimensions as the ICU version.
- Confusion Assessment Method for ICU
Developed for nonpsychiatric clinicians to assess delirium. This is the non-verbal version to be used in the ICU. Assesses 1) acute onset or flucuary course; 2) inattention; 3) disorganized thinking; and 4) altered level of consciousness.
- Delirium Detection Score (DDS)
Measures severity of delirium in the ICU using eight criteria. Scores are given for each criterion based on the presenting symptoms
- Delirium Observation Screening Scale (DOSS)
A 25-item scale to facilitate early recognition of delirium based on nurses' observations during regular care.
- Delirium Rating Scale (DRS)
Measures delirium symptoms as rated by a psychiatrist or trained clinician. Has a modified 7-8 item version (DRS-R-98)
- Memorial Delirium Assessment Scale (MDAS)
A ten-item, four-point clinician-rated scale (possible range, 0-30) designed to quantify the severity of delirium.
- Nursing Delirium Screening Checklist (NuDESC)
An observational five-item scale, with each item being scored from 0-2 according to the presence and intensity of symptoms. Takes an average of 1 minute to administer, and is appropriate for use in inpatient clinical and research settings.
- Richmond Agitation Sedation Scale (RASS)
Measures the patient's level of agitation and level of sedation. It can be used in the hospital, but is primarily used in the ICU to avoid under or over sedation.
- Single Question in Delirium (SQiD)
A simple prompt question which asks, "Is this patient more confused than before?"
- The Time and Change Test
A performance based screen for detecting dementia in older adults. Based on real-world activities designed to minimize false negatives by identifying all cases of dementia. The subject is asked to perform activities such as telling the time and making a specific amount of change from the money he/she was given.
Dementia Instruments: Home
- Abbreviated Mental Test (AMT)
A 10-question assessment of mental impairment. Scored by gaining 1 point for each correct answer, with a score of 0-3 = severe impariment, 4-6 = moderate impairment, and greater than 6 = non-impaired
- Addenbrooke's Cognitive Examination Revised (ACE-R)
Screens dementia and early stages of cognitive dysfunction. It takes between 12 and 20 min (average 16) to administer and score in a clinical setting. It contains 5 sub-scores that total a mamximum score of 100 points, with each sub-score representing one cognitive domain: attention/orientation (18 points), memory (26 points), fluency (14 points), language (26 points) and visuospatial (16 points).
- Clock Drawing Task
Assesses visuo-spatial and constructional disabilities. Used as a quick screen for cognitive dysfunction. The subject draws the face of a clock. Various scoring methods have been used to rate the numbers and clock face.
- Delirium Rating Scale-Revised-98 Face-to-Face
This revised version of the Delirium Rating Scale assesses gradations of severity of delirium severity. It is a 16 item physician rated scale, with 13 items on severity and 3 items on diagnosing delirium. Rated by trained clinician.
- Digit Span Test (DST)
A measure of mental status where a list of digits is read aloud with digits increasing in length and subjects repeat them in the same order.
- General Practitioner Assessment of Cognition (GPCOG)
Developed to facilitate primary care physicians and general practicioners in detecting dementia. Consists of both patient cognitive test items and historical questions asked of an informant, and takes less than 4 minutes to administer.
- Hopkins Verbal Learning Test Revised
A word list measuring verbal learning and memory. The interviewer reads 12 words that measure total recall, delayed recall, retention and a Recognition Index can be formed.
- Informant Questionnaire on Cognitive Decline (Short Form)
Informant questionnaire that assesses changes in patients' cognitive performance over a 5 or 10 year period. It is used to assess cognitive functioning or dementia screening. An informant for the individual rates their cognitive functioning at the time of the interview compared to 5 or 10 years ago. This is the 16 item short form of the test.
- Informant Questionnaire on Cognitive Decline in Elderly (IQCODE)
A short questionnaire designed to assess cognitive decline and dementia in elderly people. The questionnaire is filled out by a relative or friend who has known the elderly person for 10 years or more.
- Memory Impairment Screen (MIS)
A brief, four-item delayed free and cued-recall memory impairment test that also uses controlled learning and cued recall to optimize encoding specificity.
- Memory Impairment Screen (MIS)
Screening test for memory impairment, Alzheimer's disease and other dementias. Assesses delayed free and cued-recall.
- Memory Impairment Screen by Telephone (MIS-T)
A brief measure conducted over the phone to test semantic memory by presenting four target words and corresponding category cues. After an interference period (2-3 mins) participants recall as many words as they can without cues, and when words are not recalled freely, interviewers provide category cues. Scores are generated based on doubling the number of words retrieved during a 'free recall' period, and adding that to the number of words retrieved during a "cued recall" period.
A brief screening test for dementia or mild cognitive impairment. It is administered by a trained interviewer in-person, with the subject completing two tasks: word registration/recall and clock drawing. Cognitive domains assessed include memory, executive function, attention, speed of processing, visual-context and visual-spatial.The Mini-Cog has been studied in both clinical and community settings.
- Mini-Mental State Exam (MMSE) In person
A screening test for dementia or mild cognitive impairment. It is administered by a trained interviewer in person with items covering: orientation to time and place, recall, naming, construction of a figure, repetition, calculation, attention/concentration, reading and writing. Cognitive domains assessed include: memory, executive function, language function, attention, speed of processing, cultural experience, visual context/visual-spatial. The Mini-Mental is one of the most widely used screening instruments in clinical and community settings.
- Mini-Mental State Examination (MMSE): Telephone Version
The telephone version of the Mini-Mental State Exam is a modified version that substitutes items that are appropriate for in-person screening dementia or mild cognitive impairment with items that can be answered over the phone. Orientation items are asked in relation to where the person lives (e.g. What state do you live in? Floor of home or building that you live on?) and naming item asks "What is it you are speaking into now?" Cognitive domains assessed include memory, executive function, language function, attention, speed of processing, cultural experience, visual context/visual-spatial.
- Modified Blessed Dementia Rating Scale
Assesses cognitive and behavioral symptoms present in dementia.
- Modified Mini-Mental State [3MS] Examination
The original Mini-Mental State Exam (MMSE) is a brief screening test for dementia. The modified version (3MS) was developed to extend the ceiling and the floor of the test, to sample a wider range of cognitive abilities and to enhance the reliability and the validity of the scores.
- Montreal Cognitive Assessment (MoCA)
A 10-minute cognitive screening tool to assist first-line physicians in detection of mild cognitive impairment.
- Short Portable Mental Status
A rapid short (10 items) screen for cognitive impairment. It detects intellectual deficits of orientation, memory and attention.
- Symbol Digit Modalities Test (SDMT)
A brief screen for organic cerebral dysfunction. The test detects brain damage and changes in cognitive functioning. It tests visual acuity, figural memory, motor skills, speed of information processing, and motivation and persistence. The subject has 90 seconds to perform a simple substitution task that involves assigning numbers with figures.
- Telephone Interview for Cognitive Status (TICS)
A screening test for cognitive impairment that was developed for use in studies where in-person administration is not feasible. Although the TICs was modeled from the Mini-Mental State Exam (MMSE), only 2 items are identical and adequate vision and the ability to read or write are not required. Eleven items cover word list memory, orientation to time and place, attention/concentration, repetition, calculation, conceptual knowledge and non-verbal praxis (tapping on phone item).
- Telephone Interview for Cognitive Status Modified (TICSM)
A screening test for cognitive impairment based on the original Telephone Interview for Cognitive Status (TICS), but differs in the word recall tasks and omits items that were difficult to verify over the telephone. These changes were made to increase sensitivity for early dementia and avoid items that are difficult to interpret over the phone. Twelve items cover word list memory, orientation to time and personal information, attention concentration, repetition, calculation, conceptual knowledge and non-verbal praxis (tapping on phone).
- Thurstone Word Fluency Test
Measures the spontaneous production of words that begin with a given letter within a limited amount of time. The subject is given one minute to produce unique words within a semantic category or starting with a specific letter. Score is the number of unique words.
- Trail Making Test
Sensitive and brief screen for cognitive impairment. Assesses attention, visual scanning, eye-hand coordination, information processing, and executive function. Subject is asked to connect a set of 25 dots in a specific pattern as quickly as possible.
- Verbal Fluency (VF)
Brief cognitive assessments where participants are tasked with naming as many words from a certain category as they can within 1-minute (category fluency task) or naming as many words starting with a particular letter as they can within 1-minute (letter fluency test).
- Wechsler Digit Span Test
Assesses attention span and immediate auditory memory. The subjects is asked to repeat a string of numbers that becomes progressively longer.
Depression Instruments: Home
- Center for Epidemiological Depression Scale (CEDS)- 10
A brief, self-report scale that measures current symptoms of depression in the general population
- Center for Epidemiological Depression Scale (CEDS)- 20
A self-report 20 item depression screening scale for use in the general population. Each symptom is asked referring to the past week. Each symptom scores from 0 (rarely/none of the time: < 1 day) to 3 (most or all of the time: 5-7 days). Common cut-points are 16+ reflects depression, although some use 19/20 for the elderly due to the number of somatic symptoms.
- Geriatric Depression Scale (GDS) - 10
A shorter (10-item) measure to detect depression in the elderly, adapted from the original 30-item Geriatric Depression Scale.
- Geriatric Depression Scale (GDS) - 4
A shorter (4-item) measure to detect depression in the elderly, adapted from the original 30-item Geriatric Depression Scale.
- Geriatric Depression Scale (GDS)- 15
A self-report screening test for depression in the elderly. This scale is unique in that there are no somatic symptoms, and it was designed to be used with elderly adults. This is the shortened version that is only 15 items instead of 30, in part to avoid respondent fatigue. Scores of 10-15 have been used to reflect moderate to severe depression.
- Geriatric Depression Scale (GDS)- 30
A self-report screening test for depression in the elderly. This scale is unique in that there are no somatic symptoms, and it was designed to be used with elderly adults in clinical or community settings. The time referenced is the past week and each item answer has a yes/no format. Scores of 21-30 are often used to reflect moderate to severe depression.
- Hospital Anxiety and Depression Scale
A brief self-assessment detecting current states of depression and anxiety (7 questions per-subscale) and severity of depression and anxiety in an outpatient clinic setting
- Patient Health Questionnaire-2 (PHQ-2)
Brief screening instrument for depression that consists of two items from the Patient Health Questionnaire (PHQ-9) instrument. Anhedonia and depressed mood/hopelessness are measured. Each item is scored on a scale of 0 (not at all) to 3 (nearly every day). Scores >= 3 are considered a positive screen for major depressive disorder, requiring further follow-up.
- Quick Inventory of Depressive Symptomatology (QID-SR-16)
A self-report depression instrument that includes 9 DSM-IV domains 1) sad mood; 2) concentration; 3) self-criticism; 4) suicidal ideation; 5) interest; 6) energy/fatigue; 7) sleep disturbance (initial, middle, and late insomnia or hypersomnia); 8) decrease/increase in appetite/weight; and 9) psychomotor agitation/retardation. The total score ranges from 0 to 27.
- The Beck Depression Inventory II
A 21-item self-report or interview based instrument designed to assess the presence and severity of depressive DSM IV symptoms. It has been used in both clinical and community settings.
- The Hamilton Rating Scale for Depression
This instrument assesses the severity of depressive symptoms in persons already diagnosed with depression, and is administered in person by clinicians trained in its use. Twenty one items rated on a 0 (absent) to 2 (clearly present) or 4 (severe) rating scale. A score of 25 or more is used to indicate moderate to severe depression.
- The Patient Health Questionnaire (PHQ-9)
Brief screening questions for assessing the severity of depression that consists of 9 items from the Prime MD instrument. The items score each of the 9 DSM-IV criteria for depression on a scale of 0 (not at all) to 3 (nearly every day) for the past 2 weeks. The following cut-points have been used: 5 = mild, 10 = moderate, 15 = moderately severe, 20 = severe.
Frailty Instruments: Home
- Brief Frailty Instrument
Four levels of classification, representing fitness to frailty: 0 = walk without help, perform basic activities of daily living (eating, dressing, bathing, bed transfers), are continent of bowel and bladder, and are not cognitively impaired; 1 = bladder incontinence only; 2 = one (two if incontinent) or more of needing assistance with mobility or activities of daily living, or has bowel or bladder incontinence; 3 = two (three if incontinent) or more of totally dependent for transfers or one or more activities of daily life, incontinent of bowel and bladder, and diagnosis of dementia. Authors validated by measures of hospitalization and mortality.
- Clinical Frailty Scale
The Clinical Frailty Scale (CFS) ranges from 1 (very fit) to 9 (terminally ill) based on descriptors and pictographs of activity and functional status. The CFS is collapsed into three categories: non-frail (CFS 1-4), mild-to-moderately frail (CFS 5-6), and severely frail (CFS 7-8). Was developed based on a community sample.
- FRAIL Scale
Identifies the level of frailty in older persons to determine if they are at high risk for further deterioration. Assesses frailty covering 5 domains: fatigue, resistance (ability to climb 1 flight of stairs), ambulation (ability to walk 1 block), illnesses (greater than 5) and, loss of weight (>5%).
- Frailty / Vigor assessment
Assesses frailty and vigor using a pretermined criteria. Frailty: age (over 80), physical function (balance and gait abnormalities, decreased shoulder strength, decrease knee strength), physical activity (infrequent walking for exercise); psychological function (depressed); medications (taking sedatives); disability (lower extremity disability); sensory function (near vision loss). and Vigorous as : age (under 80), cognition (cognitively intact), physical activity (frequent exercise other than walking), sensory function (good near vision). Sample was from the community and falls were used as the outcome.
- Gill Frailty Measure- Disability Score
Assesses data on physical frailty and cognitive status, as well as self-reported information on physician-diagnosed chronic conditions and 8 activities of daily living: walking, bathing, upper and lower-body dressing, transferring from a chair to a standing position, using the toilet, eating, and grooming. A summary disability score is calculated with a range of 0 to 16, higher scores reflecting more disability.
- Physical Frailty Phenotype
Developed using Cardiovascular Health study data, frailty is identified by the presence of 3 or more of the following 5 components: 1) Shrinking: unintentional weight loss of 10 pounds in prior year or of 5% of body weight in prior year (by direct measurement of weight); 2) Weakness: grip strength in the lowest 20% at baseline, adjusted for gender and body mass index; 3) Poor endurance and energy: as indicated by self-report of exhaustion with two questions from the CES-D scale; 4) Slowness: the slowest 20% of the population was defined at baseline, based on time to walk 15 feet, adjusting for gender and standing height; and 5) Low physical activity level: A weighted score of kilocalories expended per week was calculated at baseline, based on each participant's report (adjusted for gender). The measure was predictive of many outcomes, controlling for things like chronic conditions and function.
- Simplified Women Health Initiative Frailty Phenotype
Frailty phenotype developed to be predictive of death, hospitalizations, activities of daily living. Components of frailty include self-reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss between baseline and 3 years of follow-up. Poor physical function is scored as 2 points because this scale measures the muscle strength and walking ability components. The number of frailty components that are present are summed, yielding a range of 0 to 5. A cutpoint of 3 or more is used to define frailty. Developed using Women's Health Initiative Study.
- Vulnerable Elders Survey
Self-reported 13-item scale that identifies community-dwelling older people at risk for death or functional decline. Function-based scoring system considers age, self-rated health, limitation in physical function, and functional disabilities. A score of 3 or higher indicated a fourfold increased risk of adverse outcomes, and identified the 1/3rd of older people who were most at risk for functional decline or death.
- Winograd Screening Instrument
Self-reported screening instrument that determines an outcome of either frail or not frail. Predictive of hospital length of stay, nursing home admission and mortality. Examines the presence of any one of the 15 criteria, and scores on a range of 0-15: CVA, chronic and disabling illness, confusion, dependence in ADL, depression, falls, impaired mobility, incontinence, malnutrition, polypharmacy, pressure sore, prolonged bed rest, restraints, sensory impairment, socioeconomic/family problems.
General Health Status/Quality of Life Instruments: Home
- Missoula-Vitas Quality of Life Index_Version 15R
Similar to the Missoula-Vitas Quality of Life Index_Version 25R, but uses only 15 questions as the original 25 items was considered too long by clinicians. The instrument helps in planning care by assessing patient distress, strength and satisfaction, and issues of life closure. Five domains of quality of life are measured: 1) symptoms, 2) functions; 3) interpersonal; 4) well-being and 5) transcendence.
- Missoula-Vitas Quality of Life Index_Version 25R
Missoula-Vitas Quality of Life Index_Version 25R has 25 items that was developed based on patients in hospice setting. The instrument helps in planning care by assessing patient distress, strength and satisfaction, and issues of life closure. Five domains of quality of life are measured: 1) symptoms, 2) functions; 3) interpersonal; 4) well-being and 5) transcendence.
- Quality of Well-Being Scale (QWB)
A general health quality of life questionnaire which measures overall status and well-being over the previous 3 days in 4 major areas: physical activities, social activities, mobility, and symptom/problem complexes.
- SF-12 Health Survey
Designed to measure general health status. The original version had 36 items; this is the abbreviated version. Scoring results in two dimensions: a physical health composite score and a mental health score.
- The 36 Item Short Form Survey (SF-36)
Assesses 8 health concepts using the following criteria: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The scoring results in a physical component score and a mental health score.
- The Euro QOL five dimensions questionnaire (EQ-5D)
Defines health in terms of 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 3 response categories corresponding to no problems, some problems, and extreme problems. The instrument is designed for self-completion, and respondents also rate their overall health on the day of the interview on a 0-100 hash-marked on a vertical visual analogue scale.
Health Behaviors Instruments: Home
- The CAGE Questionnaire (Alcoholism Screen)
Consists of 4 questions designed to help screen for a diagnosis of alcoholism. Each item is scored with 0 (no) or 1 (yes). Assesses cutting down on drinking, quitting, feeling annoyed by others criticizing drinking behavior and drinking in the morning.
- The Michigan Alcoholism Screening Test (MAST)
The MAST is a 25 item questionnaire devised to detect alcoholism. It is a self-report instrument commonly used to assess lifetime-alcohol related problems and dependent alcohol-users.
- The Self-Administered Short Michigan Alcoholism Screening Test (SMAST)
A shorter version of the MAST developed to assess alcoholism. It is a self-report instrument commonly used to assess lifetime-alcohol related problems and dependent drinkers. There are 13 of the original 25 items, each scored as Yes/No.
Hearing Instruments: Home
- Finger Rub Test
A brief physical diagnostic test for hearing impairment where the examiner rubs thumb and index finger successively 1 inch from the ear, slowly withdrawing until the signal is no longer heard.
- Hearing Handicap Inventory for Elderly (HHIE)
Assesses the effects of hearing impairment on the emotional and social adjustment of elderly people. The inventory is comprised of two subscales: a 13-item subscale that explores the emotional consequences of hearing impairment, and a 12-item subscale that explores both social and situational effects.
- Hearing Handicap Inventory for Elderly Screening Version (HHIE-S)
A brief, 10-item self-administered questionnaire measuring the perceived impact (emotional and social) of hearing loss
- Whispered Voice Test
Simple Screening Test for Hearing Impairment, in which the tester stands two feet behind the individual and whispers, and the individual is asked to repeat the words. Various versions available. Designed to measure hearing loss > 25 or 30 db.
Medical Comorbidity Instruments: Home
- American Thoracic Society Division of Lung Disease Questionnaire (ATS-DLD-78A)
Contains questions regarding frequent and chronic respiratory symptoms, including: coughing, phlegm, wheezing and shortness of breath.
- APACHE II: Acute physiology and chronic health evaluation
A severity of disease classification system used in an intensive care setting. Score is calculated from patient's age and 12 physiologic measurements: 1) AaDO2 or PaO2; 2) temperature (rectal); 3) mean arterial pressure; 4) pH arterial; 5) heart rate; 6) respiratory rate; 7) sodium (serum); 8) potassium (serum); 9) creatinine; 10) hematocrit; 11) WBC; and 12) Glasgow Coma Scale. Total score ranges from 0 to 71.
- Burden of Illness Score for Elderly Persons
A Risk Adjustment Index that predicts 1-year mortality after hospitalization. It assesses presence of diseases, physiologic abnormalities and functional impairments. Based on administrative, laboratory and medical chart data. Designed for use with hospitalized elderly patients.
- Charlson Index
Method for classifying comorbid conditions that considers the number and the severity of a list of 19 medical conditions. Developed as a predictor of mortality. Updated version uses ICD-10 codes found in administrative data.
- Chronic Disease Score (CDS)
A measure of chronic disease status derived from pharmacy data based on history of dispensed drugs for one year.
- Cumulative Index Illness Rating Scale (CIRS)
Method for rating chronic illness burden-reviews illnesses by organ system. This version was developed for use with older adults. The systems measured include Heart, Vascular, Hematopoletic, Respiratory, ENT, Upper GI, Lower GI, Liver, Pancreas & Biliary; Renal, Genitourinary, Musculoskeletal and skin, Neurologic, Endocrine and Breast and Psychiatric. Total score ranges from 0-56. Each item is rated on a scale from 0 (no problem) to 4 (extreme problem or needs treatment). Manual Guidelines for scoring available from Dr, Miller at the University of Pittsburgh.
- Elixhauser Index
Includes 30 categories of comorbid conditions based on the ICD diagnosis codes. It has a high ability to predict length of stay, hospital charges, and in-hospital death.
- Functional Comorbidity Index
A self-administered comorbidity questionnaire. It includes 18 diagnoses and is scored by totaling the number of "yes" answers, with a score of 0 indicating no comorbid illness and 18 indicating the highest number of comorbid illnesses.
- Geriatric Index of Comorbidity
A measure of comorbidity that takes into account both the number of diseases and disease severity. Validated for disability and mortality outcomes.
- Medication-Based Disease Burden Index
Alternative approach to measuring comorbidity that uses medication lists (mostly medications taken chronically, used for one condition on the list, or others based on an expert panel). Includes medications for 20 chronic disease categories.
- The APACHE III Prognostic System
APACHE III (Acute Physiology, Age, Chronic Health Evaluation) is a severity of disease classification system revised from the second version. Revisions include different physiological variables, and accounts for variation across hospitals. See Apache II for further descriptive information.
- The High Risk Diagnoses for the Elderly Scale
A risk-adjusment index for 1-year mortality based on Administrative Discharge Diagnoses. Includes 10 high-risk medical diagnoses assigned weights ranging from 1 (diabetes/pneumonia) to 6 (lymphoma/leukemia). Validated in hospital patients with the outcome of one-year mortality.
- The Index of Coexistent Diseases (ICED)
Stratifies patients according to their probability of experiencing full recovery from hip replacement surgery and having good functioning. Medical records were reviewed based on 3 conditions: severity of disease, co-existent disease and post-operative complications.
- The WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index
Developed to measure symptoms and physical disability for people with osteoarthritis of the hip and/or knee.
Medication Adherence Instruments: Home
- Everyday Cognitive Battery
Consists of four tests to assess older adults' everyday cognitive ability (based in three functional domains: medication use, finanacial planning, food preparation/nutrition): inductive reasoning test (42-items), Knowledge test (30-items), Declarative Memory Test (30-items), Working Memory Test
- Functional Limitations Assessment
A set of assessments to determine barriers older adults may encounter in taking their medications (e.g. to remember, to read small type, to differentiate meds by color and size, to open medication containers, and to interpret written instructions). Although not a standardized assessment, it is a way to identify potential problem areas for older adults.
- Medication Management Test
A test simulating certain tasks (e.g. calculation and manipulation of meds) involved in the self-administration of medications to assess high-level adaptive functioning in early dementia
- Medication Regimen Adeherence Capacity Test
An instrument that assesses a patient's capacity to adhere to a medication regimen before beginning the regimen
- Observed Tasks of Daily Living (OTDL)
Observational assessment of patient's ability to complete three key activities of daily living (e.g. food preparation; medication-related tasks; phone-related tasks) in a natural setting
- Reading/Comprehension and Task Performance Tool
A semi-structured interview and observation to identify how prescription instructions are read and medications self-administered by patients in charge of their own medication regimens
- Self-Administration of Medication Tool
A 29-item assessment completed in the hospital setting to determine a patient's ability to manage their regularly scheduled medications after discharge.
- Self-Medication Risk Assessment Instrument
A brief assessment to identify patients that may have difficulty managing their medication safely
- Structured Assessment of Independent Living Skills (SAILS)
A 50-task measure assessing older adults activities of daily living in 10 areas of everyday functioning (fine & gross motor skills, dressing, eating, expressive language, receptive language, time and orientation, money-related skills, instrumental activities, and social interaction).
- Timed Activities of Daily Living (TIADL)
A timed assessment of older adults ability to perform tasks related to five instrumental activities of daily living (Communication, finances, food, shopping, medications)
Miscellaneous Instruments: Home
- Borg Index for Dyspnea
The scale is commonly used for measuring angina pain and breathlessness (dyspnea), musculoskeletal pain and other kinds of somatic symptoms.
Other Instrument Libraries Instruments: Home
- (PROMIS®) Patient Reported Outcomes Measurement Information System
A set of person-centered measures that evaluates and monitors physical, mental, and social health in adults and children. It can be used with the general population and with individuals living with chronic conditions.
- ASCQ-Me® (Adult Sickle Cell Quality of Life Measurement Information System)
A patient-reported outcome measurement system that evaluates and monitors the physical, mental, and social well-being of adults with sickle cell disease (SCD).
- Neuro-QoL (Quality of Life in Neurological Disorders)
A measurement system that evaluates and monitors the physical, mental, and social effects experienced by adults and children living with neurological conditions.
- NIH Toolbox
A comprehensive set of neuro-behavioral measurements that quickly assess cognitive, emotional, sensory, and motor functions from the convenience of an iPad.
- Psychological measures associated with cancer
Provides psychological measures developed at the University of Rhode Island Cancer Prevention Center
- Quality of Life Resources--American Thoracic Society
The goal of this web site is to provide information about quality of life and functional status instruments that have been used in the assessment of patients with pulmonary disease or critical illness.
Pain Instruments: Home
- McGill Pain Questionnaire (MPQ)
Assesses 3 major classes of word descriptors, sensory, affective, and evaluative, that are used to measure a patient's subjective pain experience. Designed to provide quantitative measures of clinical pain that can be analyzed statistically. 20 items measure the quality and intensity of pain, 10 items measure sensory aspects, 5 items measure affective descriptors, 1 item measures evaluative, and 4 items measure miscellaneous.
- Numeric Pain Rating Scale (NPRS)
Assesses pain using an 11-point numeric scale. Ranges from 0 (no pain) to 10 (pain as bad as you can imagine/worst pain imaginable).
- The Brief Pain Inventory (BPI)
Assesses pain intensity, interference with activities, relief, quality and cause of pain.
- The McGill Pain Questionnaire Short Form (MPQ-S)
Assesses the sensory, affective and evaluative dimensions of the pain experience. Useful in situations where the standard McGill Pain Questionnaire takes too long to administer. A total of 10 items measure sensory aspects, and 4 items measure affective descriptors.
- The West Haven-Yale Multidimensional Pain Inventory
The inventory examines the impact of pain on patients' lives, the responses of others to the patients' communications of pain, and the extent to which patients participate in common daily activities.
Physical Activity/Performance Instruments: Home
- 400 M Walk -Usual
Assesses mobility limitation in older adults. Subject is asked to walk at a steady and constant pace. Usually used for older adults 75 years of age and over, whereas the fast pace walk is used for 65-74 year olds.
- 400 M Walk-Fast Paced
Asseses cardiorespiratory fitness. Subject is given 2 minutes for a warm up walk then told to walk 400 meters as quickly as possible. At the end of the test, heart rate, blood pressure and respiratory rate are measured. Gait speed is calculated as distance divided by time.
- 6-minute Walk - Exercise test in elderly patients
A 6-minute walk to assess the aerobic capabilities and gait speed of older adults. The subject walks as far as they can in 6 minutes. Vital signs and distance are measured at the end. The Borg Rate of Exertion Scale is often filled out as well as the Borg dyspnea measure.
- A Performance Oriented Assessment of Mobility
A set of balance and gait assessments to measure mobility. Originally used as an outcome measure for a fall intervention trial. There are 13 balance movements and 9 gait movements, and each is rated as normal (2), adaptive (1) and abnormal (0). Used to predict falls and progress in therapy
- CHAMPS Activities Questionnaire for Older Adults
Assesses physical activity outcomes in intervention research studies. There are 41 items that ask about physical, recreational and social activities. For each item, the subject is asked the total amount of time spent on each activity per week. Score is METS-calculated from calories and frequencies of activities.
- EPESE Short Physical Performance Battery
This battery was developed to assess lower extremity performance in individuals living in the community. Evaluates performance in 3 categories: chair stands, standing balance and walking speed.
- Fast 23-The Fitness Arthritis and Seniors Trial
Determines the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. Also measures pain and physical performance.
- Measure of Older Sedentary Time (MOST)
Assesses time spent in behaviors common among older adults: watching television, computer use, reading, socializing, transport and hobbies, as well as a summary measure (total sedentary time).
- Nagi Scale of Physical Performance (Mobility)
Assesses limitations in seven activities that reflect mobility. Final scoring results in two components: a) Index of Work Disability and b) Index of Independent Living.
- The Berg Balance Scale
Balance scale that was developed to assess patient status over time and the effectiveness of interventions. Assessess static and dynamic balance by using tasks performed in everyday life.
- The Physical Activity Scale for the Elderly (PASE)
Designed to assess physical activities in older adults by including age-specific activities. Validation studies have been conducted with falls, balance, gait, and coronary heart disease.
- The Physical Performance Test
Observed performance tests that assess different aspects of physical function. Assesses multiple domains of physical function using observed performance of tasks that simulate activities of daily living, varying in degree of difficulty.
- Yale Physical Activity Survey (YPAS)
Measures physical function and Activities of Daily Living. There are 2 sections: the amount of activity performed during a typical week in the past month, and activities performed in the past month. The final score weights each item to create an energy expenditure index.
Physical Disability Instruments: Home
- A Brief Instrumental Activities of Daily Living Measure (Fillenbaum)
Assesses level of independence in the ability to perform 5 activities: travel, shop, prepare meals, perform housework, and manage finances. It has been used as a screening instrument to determine who may require a fuller assessment of functional capacity.
- A Guttman Scale of Functional Health
Three questions on illness and functioning designed to be used in survey (self-report) research. These three items form a Guttman Scale range from 0 to 6. The items assess walking 1/2 mile, climbing stairs and doing heavy work.
- ADL: Independence in Activities of Daily Living (EPIC)
Measure of function in aging population. Assesses ability to perform self-care activities. EPIC study asked about bathing, grooming, transfer and walking. There are additional items in original scale assessing dressing, toileting, continence and walking. In the original article, grooming and walking were not included. Grooming and walking items are in the OARS instrument.
- BADL Section: The OARS Multidimensional Functional Assessment Questionnaire
Measure of functioning in older adults. Assesses capacity to perform 15 areas of functioning: telephone, travel, shopping, cooking, doing housework, taking medicine, handling money, feeding, dressing, grooming, walking, transfer, bathing and toileting. Also asks about whether another person helps with the activities.
- Barthel Index (BI)
Measures functioning in personal care and mobility. Completed from medical records, direct observation or self-report. Specifically addresses: feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, bed-to-chair transfer, mobility on level surfaces and stairs.
- Falls Efficacy Scale (FES)-10 Category
Measures confidence in performing daily activities without falling. This version assesses confidence for performing ten activities that require transferring, bending, reaching, or walking. Responses range from 1 to 10, with higher scores indicating greater confidence in maintaining daily living activities.
- IADL: Instrument Activities of Daily Living-OARS Multilevel Functional Assessment Questionnaire
Assesses ability to perform activities needed to live independently in the community. This includes the ability to use the telephone, travel, shop, cook, do housework, take medicine, handle money, feed self, dress, groom, walk, transfer, bathing and toileting.
- Index of Activities of Daily Living ADL (Original Katz Article)
Developed to measure physical functioning of older and chronically ill patients. Used to assess severity of illness and treatment efficacy. Six activities are assessed: 1) bathing; 2) dressing; 3) using toilet; 4) transfer from bed to chair; 5) continence; and 6) feeding.
- Lawton and Brody Instrumental Activities of Daily Living Scale (LB-IADL)
Assesses level of independence in 8 different activities, with 5 levels of descriptors given for each activity. Part of the Physical Self Maintenance Scale. Activities include using the telephone, shopping, food preparation, housekeeping, laundry, transportation, medication and finances.
- Pepper Assessment Tool for Disability (PAT-D)
A self-administered questionnaire consisting of 23 items that assess mobility, activities of daily living (ADL) and instrumental activities of daily living (IADL). Responses are made on a 5-point Likert scale ranging from 1 (usually did with no difficulty) to 5 (unable to do).
- Physical Self-Maintenance Scale (PSMS)
Disability measure for use in evaluating older adults in the community or institutions. Assesses ability to perform 6 self-maintenance activities independently. This is the original version of the scale which has 5 descriptors to use in rating each item. Items include toileting, bathing, dressing, feeding, grooming and ambulation.
- Physical Self-Maintenance Scale-Self-Rated Version (MAI)
Assesses ability to perform different domains of overall functioning. Extracted from the Multilevel Assessment Instrument (MAI). The domains covered include health, activities of daily living, cognition, time use, social interaction, psychological wellbeing and perceived environmental quality.
- The Functional Status Index
Measure of function that can be used to assess the efficacy of the management of some chronic disabling conditions. Measures difficulty, dependence and pain in performing 18 ADLs. Designed for use on adults with arthritis living in the community.
Sleep Instruments: Home
- Insomnia Severity Index
A brief self-report screening instrument that measures the respondent's perception of their insomnia. Seven items are rated on a scale of 0-4: difficulty falling asleep, staying asleep, waking too early, satisfaction with sleep, how noticeable sleep problems are to others, interference with daily function, and distress caused by sleep difficulties.
- The Epworth Sleepiness Scale (ESS)
Assesses daytime sleepiness with 8 self-report items. The subject rates their usual chance of dozing off or falling asleep while carrying out 8 activities: sitting and reading, watching TV, sitting in a public place, passenger in a car for over an hour, lying down in the afternoon, sitting and talking to someone, sitting quietly after lunch, and in a car while stopped for a few minutes.
Social Support Instruments: Home
- Duke Social Support and Stress Scale
Assesses the stress and support one receives from family, neighbors, coworkers and others. Validated with several comparison instruments. Scored on a scale from 0 (None) to 2 (A lot), and calculate a score out of 100.
- Krause and Markides Social Support Index
Assesses informational, tangible, emotional and integration measures of social support, as well as satisfaction with support. For use in studies of stress, social support and health among older adults.
- MacArthur Community Study of Aging: Social Support Battery
Assesses respondent's perceptions of their social support. Questions assess the structural, emotional, instrumental,demands/critcism and provisional dimensions of social support.
- The Medical Outcomes Study Social Support Survey
Self-administered social support scale that assesses five categories of support: structural, tangible, affectionate, positive social interaction and emotional/informational support.
- The Social Support Questionnaire
Developed to measure availability and satisfaction with social support. This instrument contains 27 items and was designed for research. For each item, subject is asked to list people whom they could rely on in sets of circumstances (availability) and how satisfied they are with support given.
Vision Instruments: Home
- Contrast Sensitivity: Pelli-Robson Chart
A letter chart designed to measure the subject's contrast sensitivity. Contrast sensitivity scores can be used as a screen for visual diseases which would not be picked up by visual acuity measures.
- Near Vision-Rosenbaum Card
A screening test for visual impairment in near vision. Scores are expressed as a fraction determined by the last line read. For example 20/30 means that from 20 feet away the subject can read a line that people with normal vision can read from 30 feet.
- Visual Acuity-Snellen Card
A screening test for impairment in visual acuity. Consists of reading lines of letters from 10 feet away. One eye is covered and the subject is asked to read the smallest letter line. Lines range from 20/200 to 20/20.