New technology-based functional assessment tools should avoid the weaknesses and proliferation of manual functional assessments

Background: Formal functional assessment tools for use with older adults have been in widespread use since the 1960s. Instruments have been designed to assess a wide range of different aspects of a person's everyday life. This article seeks to document the evolution of the tools used in such a way as to inform the development of the field. Study Design and Setting: The Medline, CINHAL, and Science Direct databases were searched for relevant literature relating to the functional assessment of older adults. After analysis of initial results, a second-stage search was conducted to find literature relating to the use and validation of instruments found initially. Results: Four categories of functional assessment instruments were identified for the purposes of this article: basic activities of daily living (ADLs), instrumental ADL, global health scales, and performance-based tests of functional ability. These categories and several of the most widely used tools therein are discussed chronologically to document the evolution of the field. Conclusions: With the advancement of technology has come the possibility to perform functional assessments in new ways. This outline of the evolution of functional assessment should be of considerable use as researchers seek to design new functional assessments for older adults.