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The Lawton Instrumental Activities of Daily Living (IADL) Scale is an eight-item instrument that measures a person’s ability to perform the more complex tasks required for independent community living, scored from 0 to 8. This page covers the eight domains, standard scoring, the scale’s historical gender-scoring convention, and how it differs from the Katz Index of Independence in Activities of Daily Living, which measures basic self-care rather than instrumental tasks. For related bedside functional-status instruments, see CASRAI’s Barthel Index and Functional Independence Measure pages.
What the Lawton IADL is, and who built it
The scale was developed by M. Powell Lawton and Elaine M. Brody and published in 1969 (Lawton MP, Brody EM, “Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living,” The Gerontologist 9(3):179–186), as a companion to basic-ADL instruments like the Katz Index — the distinction the paper’s own title draws between “self-maintaining” (basic self-care) and “instrumental” (higher-order, community-living) activities is the conceptual split that still organizes geriatric functional assessment today. It is free to use and reproduce, with no license fee or required certification.
The eight domains and scoring
Each domain is scored according to the person’s highest level of independent functioning within that category, using graded response options specific to the task (for example, ranging from “operates telephone on own initiative” down to “does not use telephone at all”). For a summary total, each domain contributes 1 point if the person functions independently in it and 0 points if they do not, giving a total range of 0 (low function, fully dependent) to 8 (high function, independent).
| Domain | What it assesses |
|---|---|
| Ability to use telephone | Looking up numbers, dialing, and operating a telephone independently |
| Shopping | Independently taking care of most or all needed shopping |
| Food preparation | Planning, preparing, and serving adequate meals independently |
| Housekeeping | Maintaining the home alone or with occasional help for heavy work |
| Laundry | Doing personal laundry completely |
| Mode of transportation | Traveling independently, whether driving, using public transit, or arranging taxis |
| Responsibility for own medications | Taking correct medications at the correct dose and time without help |
| Ability to handle finances | Managing money, paying bills, and handling banking independently |
The historical gender-scoring convention, and current practice
As originally published in 1969, women were scored on all eight domains, while men were traditionally not scored on food preparation, housekeeping, and laundry — three domains the original authors treated as not applicable to the male social role of the era, capping a man’s maximum summary score at 5 rather than 8. This convention still appears in some older charting templates and secondary sources describing the scale. Current geriatric-assessment guidance is to assess all eight domains for both genders, since the underlying tasks (arranging meals, keeping a home, managing laundry) are relevant functional-independence measures regardless of who has historically performed them in a given household. A chart or research protocol using the Lawton IADL should state explicitly whether all eight domains were scored, rather than assume the reader knows which convention was applied.
Interpreting the total score
A higher score indicates greater independence; a lower score indicates greater dependence on others for instrumental tasks. Unlike the Katz ADL and Barthel Index, the Lawton IADL does not have a single, universally cited set of numeric interpretation bands (e.g. a specific cutoff for “moderate” vs “severe” impairment) in the original publication — in practice, clinicians typically use the total score alongside a domain-by-domain review, since which specific tasks a person can no longer manage (finances and medications, versus transportation and shopping) often matters more for care planning than the summary number alone.
Lawton IADL vs. Katz ADL
The Lawton IADL and the Katz ADL are frequently used together in a comprehensive geriatric assessment, but they measure different tiers of function. The Lawton IADL assesses complex, higher-order tasks — telephone use, shopping, food preparation, housekeeping, laundry, transportation, medication management, and finances — that generally require more cognitive involvement and are typically the first abilities lost as a person’s function begins to decline. The Katz ADL assesses basic self-care tasks — bathing, dressing, toileting, transferring, continence, and feeding — that are typically the last abilities lost. A person who is independent on Katz ADL but impaired on Lawton IADL is a common, clinically meaningful pattern that often signals early functional decline before basic self-care is affected, which is part of why the IADL scale is widely used to flag emerging risk before a Katz ADL score would.
Reliability and what it misses
The Lawton IADL is quick to administer via patient or caregiver interview, or a review of recent documented performance, and it has been used across a large body of published aging and disability research since 1969. Its main limitation is that instrumental tasks are inherently harder to observe directly at the bedside than basic self-care activities — a clinician can watch a patient attempt to transfer from a bed, but rarely watches them manage their own bank account — so IADL scoring more often relies on self-report or a caregiver’s report than direct observation, which introduces more room for recall or informant bias than the more behaviorally observable Katz ADL items. It also does not assess mood or formal cognitive status on its own, though performance on complex instrumental tasks is frequently used as an informal early signal of cognitive decline warranting further evaluation.
Use in practice
The Lawton IADL is used in geriatric consults, home-safety and independent-living evaluations, care-management intake assessments, and discharge planning to help determine whether a patient can safely return to independent living or needs supported living, home health services, or a higher level of care. Because IADL loss commonly precedes ADL loss, a declining IADL score in an otherwise independent older adult is often treated as an early flag warranting a fuller functional and cognitive workup, not just a number to record and move past.
Frequently asked questions
What are the eight domains of the Lawton IADL scale?
Ability to use the telephone, shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility for own medications, and ability to handle finances. A summary score ranges from 0 (low function, dependent) to 8 (high function, independent).
Why were men historically scored differently on the Lawton IADL?
As originally published in 1969, men were not scored on food preparation, housekeeping, and laundry, reflecting the social role assumptions of the era, capping their maximum score at 5. Current guidance is to assess all eight domains for both genders.
What is the difference between the Lawton IADL and the Katz ADL?
The Lawton IADL measures complex, higher-order tasks needed for independent community living (telephone, shopping, food preparation, housekeeping, laundry, transportation, medications, finances), which are typically lost earliest as function declines. The Katz ADL measures basic self-care tasks (bathing, dressing, toileting, transferring, continence, feeding), which are typically lost last. The two scales are usually used together, not as substitutes.
Is the Lawton IADL a licensed or proprietary instrument?
No. It is free to use and reproduce, with no license fee or required certification.
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