BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Multilevel Assessment Instrument (MAI) Year: 1982 Domain: Biological, Psychological, Social Assessment Tool Category: General Health Variations/Translations: Mid-length, Short, and Best Item versions available. Setting: Home Method of Delivery: In-home interview Description: The MAI was designed to measure the general health state of elderly persons living in a community setting. The MAI covers 7 dimensions of health including: physical health, cognition, activities of daily living, time use, social relations/interactions, personal adjustment, and perceived environment. Most of the dimensions are divided into subscales (total of 14 subscales), with each subscale containing between 3 and 24 items. The MAI is comprised of 147 items that cover the 7 dimensions, plus an additional 81 items that cover medical and demographic information. The MAI was built on existing measurement instruments, most importantly the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ). While some information for the MAI has to be obtained from the elderly subject themselves, much of the information can also be obtained from a spouse, informal caregiver, etc. (McDowell & Newell, 1996). Scoring/Interpretation: Scores are given for each subscale based on the number of items checked off. Subscale scores can be added to give scores for the 7 dimensions. Time to Administer: 50 minutes Availability: The full-length MAI and manual for use is available on the Madlyn and Leonard Abramson Center for Jewish Life (formerly the Philadelphia Geriatric Center) website and may be reproduced with proper attribution to the Center (see website address below). Software: N/A Website: http://www.hospitalsoup.com/listing/32349-philadelphia-geriatric-center Quantitative/Qualitative: Quantitative Validity (Quantitative): Studies evaluating clinical/biological validity of the MAI had correlation levels ranging from low to moderate. One study reported that the MAI had a low ability to distinguish between respondents living in the community and respondents living in long-term care facilities, with correlations for the seven dimensions ranging from 0.05-0.54. When the MAI was compared with a psychologist’s independent rating of 590 individuals, correlation for the cognition dimension was only 0.23, while correlations for the other dimensions ranged from 0.59-0.69. When compared with ratings made by a housing administrator, correlations for the seven dimensions of the MAI ranged from 0.12-0.59 (McDowell, 2006). Reliability (Quantitative): Studies found the inter-rater reliability to be moderate to high (agreement between two raters was within a 1-point discrepancy for 95% of the ratings) (McDowell, 2006). Test-retest reliability at three weeks was found to be moderate to high (0.55-0.99) for all dimensions except activities of daily living, which only had a correlation of 0.35 (McDowell & Newell, 1996). References: Lawton, M. P., & Lawrence, R. H. (1994). Assessing Health. In M. P. Lawton & J. A. Teresi (Eds.), Focus on Assessment Techniques: Annual Review of Gerontology and Geriatrics (Vol. 14). New York: Springer Publishing Company. McDowell, I., & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires (2nd ed). New York: Oxford University Press. Comments: Further validity analysis needs to be conducted for this scale (McDowell & Newell, 1996).