Single question about total lying time for assessing physical inactivity in community-dwelling older adults: a study of reliability and discriminant validity from sleeping time.

[Purpose] To investigate reliability and discriminant validity of a single question about total lying time for assessing physical inactivity in community-dwelling older people. [Participants and Methods] The participants were 54 healthy older individuals (mean age, 72.5 years), who were asked to recall retrospectively their mean total lying and sleep times per day in the previous week (7 days). The total lying and sleep times per day in the forthcoming week (7 days) were also investigated prospectively after confirming the mean total lying and sleep times per day in the previous week, and their mean values per day were calculated. [Results] Intraclass reliability of total lying and sleep times per day in the forthcoming week were acceptable [ICC (1, 1) for total lying time=0.835, ICC (1, 1) for sleep time=0.707]. No significant difference in average total lying time between the previous (8.4 ± 2.0 hours/day) and forthcoming (8.7 ± 1.7 hours/day) weeks was seen. In the forthcoming week, average total lying time was significantly higher than average sleep time (7.1 ± 1.3 hours/day). There was low significant correlation between total lying time and sleep time. [Conclusion] Total lying time can be measured with acceptable reliability and discriminant validity, and is a different outcome than sleep time in community-dwelling older adults.

One question might be capable of replacing the Shoulder Pain and Disability Index (SPADI) when measuring disability: a prospective cohort study.

QUESTIONS: Is it possible to replace the Shoulder Pain and Disability Index (SPADI) with a single substitute question for people with shoulder pain, when measuring disability and how well does this substitute question perform as a predictor for recovery. DESIGN: A prospective cohort study. PARTICIPANTS: A total of 356 patients with shoulder pain in primary care. ANALYSES: Convergent, divergent, and "known" groups validity were assessed by using hypotheses testing. Responsiveness was assessed using the Receiver Operating Curve and hypothesis testing. In addition, we performed multivariate regression to assess if the substitute question showed similar properties as the SPADI and if it affected the model itself, using recovery as an outcome. RESULTS: The Spearman correlation coefficient between the total SPADI score and the substitute question was high, and moderate with the Shoulder Disability Questionnaire. The correlation between the substitute question and the EQ-5D-3L was low and the responsiveness was acceptable. The substitute question did not significantly contribute to both prognostic prediction models as opposed to the SPADI. Regardless all models showed poor to fair discrimination. CONCLUSION: The single question is a reasonable substitute for the SPADI and can be used as a screening instrument for shoulder disability in primary clinical practice. It has slightly poorer predictive power and should therefore not be used for prognosis.

Validating a single-question depression measure among older adults.

BACKGROUND: A single-item depression measure may not be adequate in capturing the complex entity of mental health, despite wide use of this indicator in community studies. This study evaluated the accuracy of a single-question depression measure in comparison to two composite indices-the Center for Epidemiologic Studies Depression Scale (CESD) and the Geriatric Depression Scale (GDS). MATERIALS AND METHODS: A total of 800 elderly participants ranging from 60 to 89 years of age and residing in Seoul were recruited using a multistage sampling scheme in 2015. The survey was conducted by trained interviewers with a constructed questionnaire. Reliability and validity measures such as the Kappa index, sensitivity, specificity, PPV, NPV, and AUC were used to evaluate the accuracy of the single question measure. Socio-demographic group differences in accuracy were compared by age, sex, marital status, education, employment, and financial status. RESULTS: The prevalence of depression by a single-question measure was much lower than those of CESD and GDS (5.5%, 12.3%, and 12.1%, respectively). The sensitivity of the single-item measure, based on CESD and GDS, was extremely low at 30.6% and 36.1%. In the subgroup analysis, however, there was a marked educational discrepancy in all accuracy measures; in sensitivity, people with a university degree or higher showed about 2.4 times higher sensitivity than those having only a primary school education. CONCLUSIONS: The results show that a single-question depression measure should be used with caution. In addition, the single-question measure could substantially underestimate depression among the risk group of older adults.

Validation of a Single Question for the Evaluation of Physical Activity in Adolescents.

We aimed to assess the validity of a single question to evaluate leisure-time physical activity (PA) in adolescents. We included 209 participants (57.4% girls) aged 14-18 years from Porto, Portugal, evaluated as part of the SALTA project. A self-reported question with four answer options, designed for the EPITeen study, was used to classify the intensity level of usual leisure-time activities. Actigraph accelerometers were used to objectively measure total PA during 7 consecutive days. Since the accelerometers measured PA as a continuous variable, hierarchical cluster analysis was used to identify clusters of individuals with similar level of objectively measured PA. Correlations between self-reported and objective measures were evaluated through polychoric correlations. In girls, we found higher mean time on sedentary activities among those describing their leisure-time PA as "sitting", and an increase on the time spent on light and moderate activities with increasing intensity of PA on self-reported classification. A similar trend was found in boys, but not reaching statistical significance. The correlation between the two measures of PA was 0.42 for girls and 0.46 for boys. We found an acceptable correlation between our single question and the objectively measured PA, showing that, although the single question is not adequate to quantify the intensity of the physical activity, it allows to rank adolescents according to leisure-time physical activity.

Association between REM sleep behaviour disorder and impulse control disorder in patients with Parkinson's disease. / Relación entre el trastorno de conducta del sueño REM y el trastorno de control de impulsos en pacientes con enfermedad de Parkinson.

INTRODUCTION: The relationship between impulse control disorder (ICD) and REM sleep behaviour disorder (RBD) has not yet been clarified, and the literature reports contradictory results. Our purpose is to analyse the association between these 2 disorders and their presence in patients under dopaminergic treatment. METHODS: A total of 73 patients diagnosed with Parkinson's disease and treated with a single dopamine agonist were included in the study after undergoing clinical assessment and completing the single-question screen for REM sleep behaviour disorder and the short version of the questionnaire for impulsive-compulsive behaviours in Parkinson's disease. RESULTS: Mean age was 68.88 ± 7.758 years. Twenty-six patients (35.6%) were classified as probable-RBD. This group showed a significant association with ICD (P=.001) and had a higher prevalence of non-tremor akinetic rigid syndrome and longer duration of treatment with levodopa and dopamine agonists than the group without probable-RBD. We found a significant correlation between the use of oral dopamine agonists and ICD. Likewise, patients treated with oral dopamine agonists demonstrated a greater tendency toward presenting probable-RBD than patients taking dopamine agonists by other routes; the difference was non-significant. CONCLUSIONS: The present study confirms the association between RBD and a higher risk of developing symptoms of ICD in Parkinson's disease.

Comparative validity and repeatability of a single question, a twenty-eight-item FFQ and estimated food records to assess takeaway meal intake.

A single question (SQ) and a twenty-eight-item FFQ to measure takeaway meal intake were compared with two 7-d estimated food records (EFR; reference method). Test methods were completed after the reference period and repeated 6-8 d later for repeatability. The SQ asked about intake of high-SFA takeaway meals. FFQ items included low- and high-SFA meals. Test methods were compared with EFR for sensitivity, specificity, and positive and negative predictive values, using a goal of ≤1 high-SFA weekly takeaway meals. Bland-Altman analyses were used to check agreement between measurement approaches, the κ coefficient was used to summarise the observed level of agreement, and Spearman's correlation was used to assess the degree to which instruments ranked individuals. Young adults were recruited from two universities, and 109 participants (61 % female) completed the study. The mean age was 24·4 (sd 4·9) years, and the mean BMI was 23·5 (sd 3·7) kg/m2. The SQ and the FFQ had a sensitivity of 97 and 83 % and a specificity of 46 and 92 %, respectively. Both methods exhibited moderate correlation for measuring total and high-SFA takeaway meal intakes (r s ranging from 0·64 to 0·80). Neither instrument could measure precise, absolute intake at the group or individual level. Test methods ranged from fair (κ w =0·24) to moderate agreement (κ w =0·59). The repeatability for all was acceptable. The FFQ identified excessive high-SFA takeaway meal intake and measured individuals' category for total and high-SFA takeaway intakes. Both methods are suitable for ranking individuals for total or high-SFA takeaway meal intakes.

The discriminant validity of single-question assessments of subjective cognitive complaints in an Asian older adult population.

Objective: To compare the discriminant validity of three different single-question assessments of subjective cognitive complaints (SCC) for dementia in a community-based older adult population in Singapore. Methods: Eligible older adults aged ≥60 were recruited into phase I for identifying those who require further assessment using the Abbreviated Mental Test (AMT) and progressive forgetfulness question (PFQ). Participants who failed either tests entered phase II and were administered various single-question assessments of SCC, such as the 8th question on the patient Ascertain Dementia 8 (AD8-8pt), informant AD8 (AD8-8info), and the 10th item on the Geriatric Depression Scale (GDS-10), followed by the Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery to identify the participant's cognitive status by a research diagnosis and DSM-IV criteria. Differences in characteristics among diagnostic groups were compared. All discriminatory indices (sensitivity, specificity, positive, and negative predictive values, overall accuracy) for these single-question assessments and their combinations with the MoCA were calculated and reported to confirm their discriminant validity in identifying the existence of subjective complaints and objective impairment. Results: A total of 3,780 participants were assessed at phase I, of which 957 entered and completed phase II. Of whom, 911 were dementia-free and 46 had dementia. The MoCA (13/14) displayed good sensitivity (95.6%), specificity (81.5%), and overall accuracy (82.1%) for dementia detection. The GDS-10 and AD8-8pt showed poor discriminant validity, while the AD8-8info had the highest specificity (83.2%) and the greatest overall accuracy (82.5%) for dementia. Compensatory combination of the AD8-8info with MoCA, the sensitivity and positive predictive values were optimized (100%), while the conjunctive combination of two tools achieved excellent specificity (96.3%) and overall accuracy (94.8%) in discriminating dementia patients. Conclusion and implications: Combining a reliable single-question SCC assessment with an objective tool can efficiently discriminate dementia patients from healthy older adults in the community.

The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference.

The assessment of diurnal preference, or the preferred timing of sleep and activity, is generally based on comprehensive questionnaires such as the Horne-Östberg (HÖ). The aim of the present study was to assess the reliability of a subject's self-classification as extremely morning (Self-MM), more morning than evening (Self-M), more evening than morning (Self-E) or extremely evening (Self-EE) type, based on the last question of the HÖ (Self-ME). A convenience sample of 461 subjects [23.8 ± 4.7 years; 322 females] completed a full sleep-wake assessment, including diurnal preference (HÖ), night sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Karolinska Sleepiness Scale, KSS), and habitual sleep-wake timing (12 d sleep diaries; n = 296). Significant differences in HÖ total score were observed between Self-ME classes, with each class being significantly different from neighboring classes (p < 0.0001). Significant differences in sleep-wake timing (bed time, try to sleep and sleep onset, wake up, and get up time) were observed between Self-ME classes. Such differences were maintained when sleep-wake habits were analysed separately on work and free days, and also in a smaller group of 67 subjects who completed the Self-ME as a stand-alone rather than as part of the original questionnaire. Significant differences were observed in the time-course of subjective sleepiness by Self-ME class in both the large and the small group, with Self-MM and Self-M subjects being significantly more alert in the morning and sleepier in the evening hours compared with their Self-E and Self-EE counterparts. Finally, significant differences were observed in night sleep quality between Self-ME classes, with Self-EE/Self-E subjects sleeping worse than their Self-MM/Self-M counterparts, and averaging just over the abnormality PSQI threshold of 5. In conclusion, young, healthy adults can define their diurnal preference based on a single question (Self-ME) in a way that reflects their sleep-wake timing, their sleepiness levels over the daytime hours, and their night sleep quality. Validation of the Self-ME across the decades and in diseased populations seems worthy.