Open AccessComprehensive Evaluation of the Functional Activities Questionnaire (FAQ) and Its Reliability and Validity
Author(s) -
David Andrés González,
Mitzi M. Gonzales,
Zachary J Resch,
A. Campbell Sullivan,
Jason R. Soble
Publication year - 2021
Publication title -
assessment
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.59
H-Index - 87
eISSN - 1552-3489
pISSN - 1073-1911
DOI - 10.1177/1073191121991215
Subject(s) - generalizability theory , psychology , neurocognitive , clinical psychology , reliability (semiconductor) , cognition , classical test theory , item response theory , confirmatory factor analysis , psychometrics , test (biology) , dementia , developmental psychology , structural equation modeling , psychiatry , statistics , medicine , power (physics) , physics , mathematics , paleontology , disease , pathology , quantum mechanics , biology
The Functional Activities Questionnaire (FAQ) is a collateral-report measure of difficulties in activities of daily living. Despite its widespread use, psychometric analyses have been limited in scope, piecemeal across samples, and limited primarily to classical test theory. This article consolidated and expanded psychometric analyses using tools from generalizability and item response theories among 27,916 individuals from the National Alzheimer's Coordinating Center database who completed the FAQ. Reliability was evaluated with internal consistency, test-retest, and generalizability analyses. Validity was assessed via convergence with neurocognitive measures, classification accuracy with impairment stage, and confirmatory factor and item response theory analyses. Demographics did not impact scores and there was strong evidence for reliability (0.52-0.95), though coefficients were attenuated when restricted in range to diagnostic groups (e.g., normal cognition). There were strong correlations with neurocognitive measures ( r s: -.30 to -.59), strong classification accuracy (areas under the curve: .81-.99), and a single-factor model had excellent fit. All items evidenced strong item response theory discrimination and provided significant information regarding functional disability, albeit within a relatively restricted range. The FAQ is a reliable and valid measure of activities of daily living concerns for use in clinical/research settings. It best assesses mild levels of functional difficulty, which is helpful in distinguishing normal cognition from mild cognitive impairment and dementia.