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In Reply: We thank Dr Allaire for drawing our attention to the inconsistency in our description of her study. Nevertheless, we used the accurate information, as described in Table 2, to assign ratings. We evaluated 10 distinct features of each study and assigned a summary rating of "poor" if 2 or more features were found to be lacking. Even discounting field work changes as minor or biased in a favorable direction, as suggested by Allaire, the study's selective samples and use of only 2 observation points mean that it is limited for the purpose of assessing general trends.

Allaire underscores the challenge in combining measures of disability and functioning into meaningful categories. For instance, the measure of IADL that she used actually includes assessments of 3 activities: heavy household work, walking up and down stairs, and walking a half mile. Of these functions, only heavy household work has traditionally been . . . [Full Text of this Article]

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