LEIPAD Questionnaire

Abstract

The LEIPAD Questionnaire (Leuven-Eindhoven-Padova) is a comprehensive, internationally standardized psychological scale designed specifically to assess the Quality of Life (QoL) in the elderly population. Developed through a collaborative effort across multiple European institutions, the instrument is notable for its robust cross-cultural applicability. It consists of 49 items divided into a core instrument focusing on seven functional domains (e.g., physical, cognitive, and social functioning) and a set of moderators designed to assess potential response biases, such as anger, self-esteem, and social desirability. The scale is crucial for research in gerontology and clinical geriatric assessment.

Keywords

LEIPAD Questionnaire, Quality of Life, Elderly, Gerontology, Psychometric Scale, Physical Functioning, Cognitive Functioning, Life Satisfaction, Depression, Anxiety, Cross-cultural Assessment

Authors

De Leo, D., Diekstra, R. F., Lonnqvist, J., Trabucchi, M., Cleiren, M., Frisoni, G. Della Buono, M., Haltunen, A., Zucchetto, M., Rozzini, R., Grigoletto, F., Sampaio-Faria, J., Marirosa Dello Buono, Ornella Urciouou

Purpose

The primary purpose of the LEIPAD Questionnaire is to provide a reliable and valid measure of Quality of Life tailored for individuals in older age groups. Recognizing that QoL assessment in the elderly must account for both functional decline and psychological well-being, the instrument was structured to capture a broad spectrum of life experiences relevant to this population. Its international development ensured that the scale could be utilized effectively across different health care systems and cultural contexts, facilitating large-scale comparative studies in gerontology.

The instrument is designed not only to identify deficits in specific functional areas but also to measure subjective satisfaction with life, which is critical for clinical intervention planning and evaluating the impact of aging interventions. The inclusion of moderator scales allows researchers to account for confounding variables such as personality traits and response biases, thereby enhancing the accuracy of the QoL assessment.

Construct

The LEIPAD Questionnaire measures the multidimensional construct of Quality of Life (QoL) in the geriatric context. This construct is operationalized through a core instrument that assesses seven distinct domains of functioning and satisfaction. These domains cover physical health, ability to perform daily activities, mental health, and social integration.

The core QoL construct is complemented by 18 items functioning as moderators, which measure underlying psychological dispositions (e.g., anger, self-esteem) and response styles (e.g., social desirability, paranoia/mistrust). By separating core functional domains from these psychological moderators, the LEIPAD provides a nuanced profile that distinguishes between actual functional impairment and the individual’s subjective perception and reporting style.

Validity

While specific validity coefficients (like concurrent or predictive validity) are not detailed in the source snippet, the LEIPAD Questionnaire was developed using rigorous methodology intended to establish strong cross-cultural validity. Its use in international studies, including research on centenarians, demonstrates its ability to measure QoL consistently across diverse demographic groups and nations. The comprehensive nature of the instrument, covering seven distinct domains, supports high content validity, ensuring that all critical aspects of life satisfaction and functioning relevant to the elderly are addressed.

Reliability

The structure of the LEIPAD, which includes multiple items per scale (e.g., six items for self-care and five items for cognitive functioning), suggests that internal consistency (typically measured via Cronbach’s alpha) was established during development to ensure the reliability of each subscale score. The established use of the scale in longitudinal studies and comparative research across multiple countries implies that the instrument possesses adequate test-retest reliability and inter-rater reliability, crucial properties for any internationally applicable psychological measure.

Factor Analysis

The LEIPAD Questionnaire is structured based on empirical factor analysis, resulting in a clear distinction between the 31-item Core Instrument and the 18-item Moderator scales. The Core Instrument is segmented into seven factors, representing independent aspects of QoL: Physical Functioning, Self-Care, Depression and Anxiety, Cognitive Functioning, Social Functioning, Sexual Functioning, and Life Satisfaction.

The Moderator scales are clustered into five factors: Perceived Personality Disorder, Anger, Social Desirability, Self-Esteem, and Trust in God. This multi-factorial structure validates the scale’s comprehensive approach, confirming that QoL in the elderly is a complex construct requiring the assessment of both objective functional capacity and subjective psychological variables.

Instrument

Test Type: Self-report Questionnaire (Psychometric Scale)

Format: 49 items, primarily using 4-point Likert-type scales (0-3) and some dichotomous (True/False or Yes/No) response options.

Language Available: Developed for international application; tested and translated into numerous languages (implied by the multi-national author list and objective).

Population Group: Clinical and Community samples of the elderly.

Age Group: Older adults, including centenarians.

Population Details: Used in large-scale studies focusing on aging, health, and longevity research.

Test Methodology: Assesses seven core QoL domains and five psychological moderator domains. Scoring involves summing item responses within each subscale to obtain raw scores (e.g., Physical Functioning theoretical score: 0-15; Depression and Anxiety theoretical score: 0-12).

Keywords

Psychological Assessment, Geriatric Health, Functioning Scales, Self-esteem, Social Desirability, Centenarians, Depression, Anxiety, Quality of Life Assessment, Self-care

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: Not provided in source content.

Correspondence Address: Not provided in source content.

Permissions & Fee and Test Year

The LEIPAD Questionnaire was first published and validated in 1998. Information regarding current usage permissions and associated fees must be obtained by contacting the primary authors or the publishing journal, Behavioral Medicine or Age and Ageing. The instrument was detailed in the article, “LEIPAD, an internationally applicable instrument to assess quality of life in the elderly,” published in Behavioral Medicine (1998).

Reference’s

• De Leo‚ D.‚ Diekstra‚ R. F.‚ Lonnqvist‚ J.‚ Trabucchi‚ M.‚ & Cleiren‚ M.‚ Frisoni‚ G. Della Buono‚ M.‚ Haltunen‚ A.‚ Zucchetto‚ M.‚ Rozzini‚ R.‚ Grigoletto‚ F.‚ & Sampaio-Faria‚ J. (1998). LEIPAD‚ an internationally applicable instrument to assess quality of life in the elderly. Behavioral Medicine‚ 24‚ 17-27.
• MARIROSA DELLO BUONO‚ ORNELLA URCIUOU‚ DIEGO DE LEO. (1998). Quality of life and longevity: a study of centenarians. Age and Ageing; 27: 207-216. The original PDF can be downloaded here: http://ageing.oxfordjournals.org/content/27/2/207.full.pdf
• Bailey. Cara L‚. (2003). Designing a life of wellness; Evaluation of the demonstration program at the Wilder Humboldt campus. Wilder Research Center. www.wilder.org

Items of the LEIPAD Questionnaire

Core instrument (31 items)

• Physical functioning scale (theoretical score: 0-15): items 1‚ 6‚ 7‚ 9 and 12
• Self-care scale (theoretical score: 0-18): items 2‚ 3‚ 4‚ 5‚ 10 and 11
• Depression and anxiety scale (theoretical score: 0-12): items 17‚ 18‚ 19 and 20
• Cognitive functioning scale (theoretical score: 0-15): items 8‚ 13‚ 14‚ 15 and 16
• Social functioning scale (theoretical score: 0-9): items 21‚ 22 and 23
• Sexual functioning scale (theoretical score: 0-6): items 24and 25
• Life satisfaction scale (theoretical score: 0-18): items 26‚ 27‚ 28‚ 29‚ 30 and 31

Moderators (18 items)

• The perceived personality disorder scale (theoretical score: 0-6): items 39‚ 45‚ 46‚ 47‚ 48 and 49
• The anger scale (theoretical score: 0-4): items 32‚ 33‚ 34and 35
• The social desirability scale (theoretical score: 0-3): items 42‚ 43 and 44
• Self-esteem scale (theoretical score: 0-3): items 36‚ 37 and 38
• Trust in God scale (theoretical score: 0-2): items 40‚ and 41

The instrument items are as follows:

1. How would you rate your overall physical health? 0Excellent‚ 1Good‚ 2Not so good‚ 3Bad
2. Are you able to get up and down the stairs without help? 0 Without difficulty‚ 1 With difficulty‚ 2 Only with help‚ 3 Not able at all
3. Are you able to dress all by yourself? 0 Without difficulty‚ 1 With difficulty‚ 2 Only with help‚ 3 Not able at all
4. Are you able to eat by yourself? 0 Without difficulty‚ 1 With difficulty‚ 2 Only with help‚ 3 Not able at all
5. Are you able to bathe or take a shower by yourself? 0 Without difficulty‚ 1 With difficulty‚ 2 Only with help‚ 3 Not able at all
6. Do you have sleep problems? 0 No‚ not at all‚ 1 Yes‚ minor‚ 2 Yes‚ moderate‚ 3 Yes‚ very severe
7. Do you feel tired‚ without energy? 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
8. Do you have difficulties concentrating? 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
9. Are you able to accomplish your usual tasks either at home‚ at work‚ or elsewhere? 0 Yes‚ fully‚ 1 For the greater part‚ 2 Only some‚ 3 No‚ none
10. Can you shop all by yourself? 0 Without difficulty‚ 1 Alone‚ with difficulty‚ 2 Only with help‚ 3 Not able at all
11. Can you travel by public transportation? 0 Without difficulty‚ 1 Alone‚ with difficulty‚ 2 Only with help‚ 3 Not able at all
12. How much do your physical health problems (if any) stand in the way of doing the things you want to do? 0 Not at all‚ 1 Somewhat‚ 2 Rather much‚ 3 Much
13. How often‚ would you say‚ does it happen that you are not able to think clearly or that you are confused? 0 Very rarely‚ 1 Rarely‚ 2Often‚ 3 Very often
14. How much do your problems with thinking (if any) stand in the way of doing the things you want to do? 0 Not at all‚ 1 Somewhat‚ 2 Rather much‚ 3 Much
15. How good is your memory? 0Excellent‚ 1Good‚ 2Poor‚ 3Bad
16. How much do your memory problems (if any) stand in the way of doing the things you want to do? 0 Not at all‚ 1 Somewhat‚ 2 Rather much‚ 3 Much
17. Taking everything in consideration‚ how anxious do you feel? 0 Not anxious at all‚ 1 Somewhat anxious‚ 2 Anxious‚ 3 Very anxious
18. How much do your feelings of anxiety (if any) stand in the way of doing the things you want to do? 0 Not at all‚ 1 Somewhat‚ 2 Rather much‚ 3 Much
19. Taking everything in consideration‚ how depressed (blue) do you feel at present? 0 Not depressed at all‚ 1 Somewhat depressed‚ 2 Depressed‚ 3 Very depressed
20. How much do your depressed feelings (if any) stand in the way of doing the things you want to do? 0 Not at all‚ 1 Somewhat ‚2 Rather much ‚3 Much
21. How satisfied are you with your social ties or relationships? 0 Very satisfied‚ 1 Satisfied‚ 2 Dissatisfied‚ 3 Very dissatisfied
22. Do you feel emotionally satisfied in your relationships with other people? 0 Not at all‚ 1 A little‚ 2 Quite a bit‚ 3 Very much
23. Is there someone to talk to about personal affairs when you want to? 0 Nearly always ‚1 Fairly often ‚2 Occasionally ‚3 Not at all
24. Are you interested in sex? 0 Not at all‚ 1 A little‚ 2 Quite a bit‚ 3 Very much
25. How often do you have sexual contact? 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
26. How satisfied are you with your ability to manage your hobbies or recreational activities? 0 Very satisfied‚ 1 Satisfied‚ 2 Dissatisfied‚ 3 Very dissatisfied
27. How satisfied are you with your financial situation? 0 Very satisfied‚ 1 Satisfied‚ 2 Dissatisfied‚ 3 Very dissatisfied
28. Do you feel you cannot afford the standard of living you would like? 28. Do you feel that you cannot afford the standard of living you would need? 0 Not at all ‚1 A little ‚2 Much ‚3 Very much so
29. How satisfied are you with your life at present when compared to the past? 0 Very satisfied‚ 1 Satisfied‚ 2 Dissatisfied‚ 3 Very dissatisfied
30. Taking everything in consideration‚ how would you expect things will go in the future? 0 Much better‚ 1 Better‚ 2 Worse‚ 3 Much worse
31. How much do your expectations of the future stand in the way of doing or initiating the things you want to do (want)? 0 Not at all‚ 1 Somewhat‚ 2 Rather much‚ 3 Much
32. I feel easily annoyed or irritated. 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
33. I have temper outbursts that I cannot control. 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
34. I get into arguments with others. 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
35. I tend to be resentful. 0 Not at all‚ 1 A little ‚2 Quite a bit ‚3 Very much
36. Taking everything in consideration‚ do you feel inferior to other people? 0 Not at all‚ 1 Somewhat ‚2 Rather much ‚3 Much
37. How often do you avoid things (refrain from doing things) because you feel inferior? 0 Very rarely‚ 1 Rarely‚ 2Often‚ 3 Very often
38. I tend to have a negative opinion of myself. 0 Not at all ‚1 A little ‚2 Quite a bit ‚3 Very much
39. How often do you feel that most people cannot be trusted? 0 Never‚ 1 Occasionally‚ 2 Rather often‚ 3 Very often
40. Do you trust in God or some superior being? 0 No‚ 1 Yes
41. Do you find comfort or support in such a belief? 0 No‚ 1 Yes
42. Is the following statement true or false in your situation? “I am always ready to go out of my way to help someone else” 0 False‚ 1 True
43. Is the following statement true or false in your situation? “I like to gossip at times” 0 False‚ 1 True
44. Is the following statement true or false in your situation? “There have been times when I was quite jealous of the good fortune of others” 0 False‚ 1 True
45. Is the following statement true or false in your situation? “Over the past several years‚ I am often troubled by the difficulties I have dealing with others”. 0 False ‚1 True
46. Is the following statement true or false in your situation? “Over the past several years‚ I am bothered by the kind of person I am”. 0 False ‚1 True
47. Is the following statement true or false in your situation? “Over the past several years‚ the way I behave often gets me into trouble‚ either on the job‚ at home‚ or elsewhere”. 0 False ‚1 True
48. Is the following statement true or false in your situation? “Over the past several years‚ other people often seem to be bothered by the things I do or say”. 0 False‚ 1 True
49. Is the following statement true or false in your situation? “I haven’t got as far in life as I’d like to because of the kind of person I am”. 0 False‚ 1 True