Propriedades psicométricas do questionário de atividades de vida diária de PFEFFER

Abstract

Pfeffers Functional Activities Questionnaire (FAQ) is one of the most commonly employed tools in studies on pathological cognitive ageing. Despite the different versions of the questionnaire translated for use in clinical practice and research in Brazil, the FAQ was only formally cross-culturally adapted to the Brazilian context in 2011. However, few studies have analyzed the psychometric properties of the Brazilian version of the FAQ (B-FAQ). Thus, this study aims to: (1) investigate the use of the FAQ in Brazil, identifying clinical groups in which it has been used, which version of the questionnaire is used in the studies, which psychometric properties were evaluated and which administration methods are used, (2) to analyze the B-FAQ with regard to internal consistency, factorial structure and associations with demographic factors (age, sex and schooling), depressive symptoms, cognitive measures and other measures of functionality. First of all, an integrative review of the literature was performed based on a search of the Lilacs, SCIELO Brazil and PUBMED databases. Forty-five studies were selected to compose the sample. Different versions of the FAQ are used in Brazil and it was not possible to conclude whether the original version is the most employed. These questionnaires are widely used for older adults with cognitive impairment. Eighteen studies on construct validity, 15 on criterion validity and one on reliability were found. No study was found addressing the ecological validity of the FAQ. The most frequent cutoff point used as an indicator of functional disability was 5 points. An interview with the informant was the most frequent form of administering the questionnaire. Considering the diversity of versions of the FAQ in the national context, it is essential that the professional has clarity about the evidence of validity of the version which uses for clinical practice and research. Therefore, the psychometric properties of one of the most used versions, the B-FAQ, were analyzed. One hundred sixty-one older adults were divided into four groups (91 with dementia, 46 with mild cognitive impairment, 11 with psychiatric disorders and 13 healthy controls). All participants were submitted to the Mini Mental Health Examination, Clock Drawing Test, Frontal Assessment Battery, Mattis Dementia Rating Scale (MDRS), Geriatric Depression Scale, B-FAQ and General Activities of Daily Living Scale. The B-FAQ demonstrated very good internal consistency ( = 0.91). Factor analysis revealed a two-factor structure, which, taken together, accounted for 66% of the variance in the findings. The B-FAQ was not correlated with demographic factors, was weakly correlated with depressive symptoms ( = 0.271, p < 0.01, R² = 7%) and strongly correlated with cognitive measures (MDRS: = -0.574, p < 0.01, R² = 33%; MDRS Initiative/Perseveration: = -0.537, p < 0.01, R² = 29%) as well as complex instrumental activities of daily living ( = -0.845, p < 0.01, R² = 71%). Cognitive (MDRS: = -0.234, SE = 0.03, p < 0.001) and behavioral (Geriatric Depression Scale: = 0.426, SE = 0.15, p = 0.007) factors were important predictors of functional performance in the population studied, demonstrating distinct sets of difficulties when the groups were compared to each other. The present findings indicate that the B-FAQ has satisfactory reliability, internal consistency and construct validity. Therefore, this questionnaire can be used in clinical practice and research involving the Brazilian population of older adults.