A Novel Longshi Scale Measured Activity of Daily Living Disability in Elderly Patients Affected by Neurological Diseases: a Multi-center Cohort Study in China

Abstract

Background: The activity of daily life (ADL) ability is often impaired in the elderly patients with neurological diseases. Barthel index (BI) is a global disability scale which can assess the performance of ADL for old people. The Longshi scale is a novel pictorial-based scale for evaluating a patient’s disability, but few studies assess the elderly patients. Hence, the aim of this study was to determine whether Longshi scale can distinguish the ADL level of the elderly people and investigate the relationship between the Longshi scale and BI in measuring ADL among the elderly disabled. Methods: This was a multi-center cross-sectional study of elderly disabled patients (more than 65 years old). The ADL levels of all patients were evaluated by both Longshi scale and BI. Patients were divided into three groups (Bedridden group, Domestic group, Community group) based on the Longshi scale, while there were four groups (slight dependence, moderate dependence, severe dependence, total dependence) according to different BI scores. The relationship between the scores of Longshi scale and BI at different level were analysed. Results: A total of 2438 consecutive patients were recruited into the study from 9 centers during a period of 6 months (from 1 Oct 2019 to 1 April 2020). There was a significant difference of the total BI scores between the three groups of Longshi scale (p<0.001). Moreover, the Longshi scale scores showed significant differences between the four BI groups in the bedridden group, domestic group and community group of Longshi scale (p<0.001), respectively. Furthermore, the Spearman correlation coefficients between the LS scores of three groups (bedridden, domestic and community group) and BI scores were 0.869, 0.848 and 0.828 (P<0.001, respectively). Conclusions: Longshi scale can efficiently distinguish the degree of ability of daily living activities among the elderly disabled and has positive correlations with the BI.