Validity of the Katz Index to assess activities of daily living by informants in neuropathological studies

Ferretti-Rebustini, Renata Eloah de Lucena; Balbinotti, Marcos Alencar Abaíde; Jacob‐Filho, Wilson; Rebustini, Flávio; Suemoto, Cláudia Kimie; Pasqualucci, Carlos Augusto; Farfel, José Marcelo; Leite, Renata Elaine Paraízo; Grinberg, Lea T.; Nitrini, Ricardo

doi:10.1590/s0080-623420150000600010

Cited by 31 publications

(28 citation statements)

References 22 publications

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“…A knowledgeable informant was interviewed to obtain the deceased’s past clinical history using a semi‐structured interview, which was previously validated for post‐mortem use . The clinical interview included information about: (i) sociodemographics: age at death, sex, years of education, race (White, Black, Brown, and Asian), frequency of contact between the deceased and the informant; (ii) history of previous medical diagnosis of hypertension, diabetes, coronary artery disease, heart failure, dyslipidemia, stroke, smoking and alcohol use; and (iii) cognitive evaluation using the Clinical Dementia Rating (CDR) .…”

Section: Methodsmentioning

confidence: 99%

Neuropathological lesions in the very old: results from a large Brazilian autopsy study

et al. 2019

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Objective To compare neuropathological correlates of cognitive impairment between very old and younger individuals from a Brazilian clinicopathological study. Methods We assessed the frequency of neuropathological lesions and their association with cognitive impairment (Clinical Dementia Rating scale ≥0.5) in the 80 or over age group compared to younger participants, using logistic regression models adjusted for sex, race and education. Results Except for infarcts and siderocalcinosis, all neuropathological lesions were more common in the 80 or over age group (n = 412) compared to 50–79 year olds (n = 677). Very old participants had more than twice the likelihood of having ≥2 neuropathological diagnoses than younger participants (OR = 2.66, 95% CI = 2.03–3.50). Neurofibrillary tangles, infarcts and hyaline arteriolosclerosis were associated with cognitive impairment in the two age groups. Siderocalcinosis was associated with cognitive impairment in the younger participants only, while Lewy body disease was associated with cognitive impairment in the very old only. In addition, we found that the association of infarcts and multiple pathologies with cognitive impairment was attenuated in very old adults (Infarcts: P for interaction = 0.04; and multiple pathologies: P = 0.05). However, the predictive value for the aggregate model with all neuropathological lesions showed similar discrimination in both age groups [Area under Receiver Operating Characteristic curve (AUROC) = 0.778 in younger participants and AUROC = 0.765 in the very old]. Conclusion and relevance Despite a higher frequency of neuropathological findings in the very old group, as found in studies with high‐income populations, we found attenuation of the effect of infarcts rather than neurofibrillary tangles and plaques as reported previously.

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Section: Methodsmentioning

confidence: 99%

Neuropathological lesions in the very old: results from a large Brazilian autopsy study

et al. 2019

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“…To gain information regarding activity specific changes, dependency in ADL for each item of the KATZ Index was analyzed. The KATZ Index has been shown to be reliable and valid in older adults [22,23].…”

Section: Data Collectionmentioning

confidence: 99%

Activity limitations and participation restrictions in people with multiple sclerosis: a detailed 10-year perspective

Conradsson

Ytterberg

Engelkes

et al. 2019

Disability and Rehabilitation

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Aim: To conduct a detailed investigation into changes in activity limitations and participation restrictions over 10 years in people with mild, moderate and severe multiple sclerosis. Methods: This study was a 10-year longitudinal study of 264 people with multiple sclerosis living in Stockholm County, Sweden. Ten-year changes in personal and instrumental activities in daily living were assessed using the Katz Activities in Daily Living Index Extended and participation in social/lifestyle activities using the Frenchay Activities Index. Results: While people with moderate multiple sclerosis, compared to baseline, demonstrated significantly higher proportions of dependency in most activities of personal and instrumental activities in daily living at the 10-year follow-up, the mild group primarily increased their dependency in instrumental activities and the severe group in personal activities. Significantly higher proportions of the moderate group showed restricted participation in domestic and outdoor activities whereas the mild group only showed restrictions in a few domains of participation. A majority of people with severe multiple sclerosis showed restricted participation in all social/lifestyle activities at baseline and the 10-year follow-up. Conclusions: Prominent long-term increases in activity limitations and participation restrictions occurred across the spectrum of disease severity but was most pronounced in those more moderately affected. ä IMPLICATIONS FOR REHABILITATION This study provides guidance with regard to specific activities that are prone to deteriorate across 10 years and thereby reflect important targets and outcomes for interventions. Increases in activity limitations and participation restrictions were most pronounced in those moderately affected by multiple sclerosis. Those mildly affected by multiple sclerosis primarily increased their dependency in instrumental activities of daily living while those severely affected increased their dependency in personal activities of daily living.

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“…The Katz scale has high content validity even in patients with neurologic decline, and lower Katz scores were predictive of adverse events in cardiovascular patients undergoing transcatheter valve replacements. 11,12…”

Section: Outcome Measuresmentioning

confidence: 99%

Effect of Delirium on Physical Function in Noncardiac Thoracic Surgery Patients

Khan¹,

Xu²,

Wang

et al. 2020

American Journal of Critical Care

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Background The effect of delirium on physical function in patients undergoing noncardiac thoracic surgery has not been well described and may differ from that in other surgical populations. Objective To determine the effects of delirium on muscle strength and functional independence. The primary end point was change in Medical Research Council sum score (MRC-SS) by delirium status. Methods A secondary analysis of data from a clinical trial involving English-speaking adults aged 18 years or older who were undergoing major noncardiac thoracic surgery. Exclusion criteria were history of schizophrenia, Parkinson disease, dementia, alcohol abuse, or neuroleptic malignant syndrome; haloperidol allergy; being pregnant or nursing; QT prolongation; and taking levodopa or cholinesterase inhibitors. Delirium was assessed twice daily using the Confusion Assessment Method for the Intensive Care Unit. Preoperatively and postoperatively, muscle strength was assessed using the modified MRC-SS and functional independence was assessed using the Katz scale of activities of daily living. Changes in MRC-SS and Katz score by delirium status were analyzed using the Fisher exact test. Results Seventy-three patients were included in the analysis. Median (interquartile range) MRC-SS and Katz score before surgery did not differ significantly between patients without and with delirium (MRC-SS: 30 [30-30] vs 30 [30-30], P > .99; Katz score: 6 [6-6] vs 6 [6-6], P = .63). The percentage of patients with a change in MRC-SS was similar in patients without and with delirium (17% vs 13%, respectively; P > .99). More patients in the delirium group had a change in Katz score (13% vs 0%, P = .04). Conclusions Postoperative delirium was not associated with change in muscle strength. Follow-up studies using other muscle measures may be needed.

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Validity of the Katz Index to assess activities of daily living by informants in neuropathological studies

Cited by 31 publications

References 22 publications

Neuropathological lesions in the very old: results from a large Brazilian autopsy study

Neuropathological lesions in the very old: results from a large Brazilian autopsy study

Activity limitations and participation restrictions in people with multiple sclerosis: a detailed 10-year perspective

Effect of Delirium on Physical Function in Noncardiac Thoracic Surgery Patients

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