Independence tests should ask more of seniors

The Activities of Daily Living, or ADL, questionnaire is a standard used by healthcare professionals to decide what services older adults need to remain independent. These activities include eating and bathing. The Instrumental Activities of Daily Life, or IADL, questionnaire is a stepped-up standard that also considers basic skills such as managing money and preparing meals.

But in her recent paper, "Adaptation for Growth Via Learning New Skills as a Means to Long-Term Functional Independence in Older Adulthood: Insights From Emerging Adulthood," Wu argues low expectations set by ADL and IADL questionnaires may be contributing to cognitive decline in healthy older adults.

"Aging research has often overlooked an important factor for long-term functional independence in a constantly changing environment: adaptation for growth via learning new skills," Wu said. This comes as the environment for maintaining independence is ever-changing, with the advent of technologies such as online banking and ride-sharing apps.

Wu said younger people have to learn new skills and adapt, including to get and keep their jobs.

"Having a high bar for functional independence for younger adults in terms of learning, growing, and adapting means that they are more likely to achieve long-term functional independence," she said.

"At some point, older adults will encounter a situation that will test their abilities to maintain functional independence," Wu said. "For example, an older adult could move to a new country and not know how to use public transportation or drive. If the older adult has been consistently learning and adapting up until that point, she likely will be more able to navigate this test of functional independence."

Wu advocates expanding the range of functional independence. At the lower end would be the ADL/IADL standards, and at the higher end, their willingness and ability to learn new, difficult real-world skills.

"The end goal is to raise the bar for older adults to better understand successful aging," Wu said.

She said further research is needed to better understand how learning new skills in old age can lead to greater long-term independence.