Rebooting Instrumental Activities of Daily Living for the 21st Century
Authors: Emily B. Fessler, Rebecca T. Brown, Rachel K. Miller
Journal: Annals of Internal Medicine (2021)

Ideas and OpinionsFebruary 2022Rebooting Instrumental Activities of Daily Living for the 21st CenturyEmily B. Fessler, MD, Rebecca T. Brown, MD, MPH, and Rachel K. Miller, MD, MSEdEmily B. Fessler, MDDivision of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York (E.B.F.)Search for more papers by this author, Rebecca T. Brown, MD, MPHDivision of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, and Center for Health Equity Research and Promotion and Geriatrics and Extended Care Program, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (R.T.B.)Search for more papers by this author, and Rachel K. Miller, MD, MSEdDivision of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, and Geriatrics and Extended Care Program, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (R.K.M.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-3065 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Over the past decades, new technologies have dramatically transformed day-to-day life for people of all ages. In 2000, only 14% of Americans older than 65 years reported using the internet; today, this has surged to 75% (1). Many adults would be hard-pressed to accomplish their goals without modern technology: Smartphones, online shopping, ride-sharing applications, and more are ubiquitous parts of daily life. Despite this cultural shift, we still chart the functional trajectories of older adults using the instrumental activities of daily living (IADLs) originally proposed in 1969 (2). Although the world has changed significantly, our metric for successful independent living ...References1. Internet/broadband fact sheet. Pew Research Center. 7 April 2021. Accessed at www.pewresearch.org/internet/fact-sheet/internet-broadband on 6 July 2021. Google Scholar2. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-86. [PMID: 5349366] CrossrefMedlineGoogle Scholar3. Millán-Calenti JC, Tubío J, Pita-Fernández S, et al. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010;50:306-10. [PMID: 19520442] doi:10.1016/j.archger.2009.04.017 CrossrefMedlineGoogle Scholar4. Quamar AH, Schmeler MR, Collins DM, et al. Information communication technology-enabled instrumental activities of daily living: a paradigm shift in functional assessment. 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Increasing mental health care access, continuity, and efficiency for veterans through telehealth with video tablets. Psychiatr Serv. 2019;70:976-982. [PMID: 31378193] doi:10.1176/appi.ps.201900104 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Emily B. Fessler, MD; Rebecca T. Brown, MD, MPH; Rachel K. Miller, MD, MSEdAffiliations: Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York (E.B.F.)Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, and Center for Health Equity Research and Promotion and Geriatrics and Extended Care Program, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (R.T.B.)Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, and Geriatrics and Extended Care Program, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (R.K.M.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-3065.Corresponding Author: Emily B. Fessler, MD, Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10065; e-mail, emf9038@med.cornell.edu.Author Contributions: Conception and design: E.B. Fessler, R.T. Brown, R.K. Miller.Analysis and interpretation of the data: R.T. Brown, E.B. Fessler, R.K. Miller.Drafting of the article: E.B. Fessler, R.K. Miller, R.T. Brown.Critical revision of the article for important intellectual content: E.B. Fessler, R.T. Brown, R.K. Miller.Final approval of the article: E.B. Fessler, R.T. Brown, R.K. Miller.Administrative, technical, or logistic support: E.B. Fessler, R.K. Miller.This article was published at Annals.org on 21 December 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics February 2022Volume 175, Issue 2Page: 278-279KeywordsAgingComputersElderlyGeriatricsHealth information technologyInstrumental activities of daily livingInternetTelemedicine ePublished: 21 December 2021 Issue Published: February 2022 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...