A systematic review and comparison of functional assessments of community-dwelling elderly patients

Abstract

Purpose To provide advanced practice nurses in primary care with information about self‐reported functional assessments and physical performance‐based functional assessments of geriatric patients living alone within the community at greatest risk of functional decline. Data sources Databases searched include CINAHL, Healthsource: Nursing/Academic Edition, MEDLINE, PsycINFO, PsycARTICLES, Cochrane Library, and National Clearinghouse Guidelines. The review was limited to English, research, and the years 2000–2014. Key search words included geriatric, community‐dwelling, functional assessment, activities and instrumental activities of daily living, Barthel Index, Katz Index, Lawton Scale, Vulnerable Elders Survey, Timed Up and Go Test, Gait Speed Test, Functional Reach Test, and primary care. Conclusions Forty‐three million individuals, age 65 and older, are currently living in the United States with numbers expected to double by 2050. Nurse practitioners will be at the forefront of assessing for functional decline and can use tools such as the Barthel Index and Gait Speed Test to improve elderly outcomes. Implications for practice Self‐reported functional questionnaires and physical functional performance tests can quickly be completed in the office to track the risk of functional decline over time. Interventions, such as physical therapy or other community resources, can be initiated when needed to reduce negative outcomes of functional decline.

Functional Capacity and Physical Exercise in Older Women Living in a Rural Environment: A Correlational Cross-sectional Study

“…These results are in line with those reported by other authors [21,22] and corroborate the need to improve the information and guidance offered to older women to encourage them to adopt a physically active lifestyle, thus promoting successful aging and preventing or delaying the development of functional limitations and situations of dependence [2,15,18,[23][24][25].…”

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

“…As recently highlighted, the scale is useful to detect independency and severe limitations. However, it is not sensitive to detect different levels of dependency and minor deviations from a previous assessment (29) . The three point scale used by the BBBABSG shall be useful in detecting levels of impairment between total independency and total dependency, once this scoring system transforms the index in an ordinal scale, instead of dichotomous.…”

“…In such cases, the informant can be the only available source of data. Yet, the gerontologist should remember the limitations proper to the scale, regarding its strict ability to detect moderate impairment or discreet changes in function (29) , and the recall period in retrospective assessments. There is no consensus on the ideal recall period, but it is assumed that the longer the recall period, the higher the chance of imprecise information (25) .…”

Thriving among older people living at home with home care services—A cross‐sectional study

“…Total score then ranged from 0–7. Lawton and Brody's IADL scale has been used extensively in research (Roedl, Wilson, & Fine, ). Lawton and Brody () showed significant concurrent validity of the IADL in relation to several other functional measures (intercorrelations between .40 – .61) and satisfactory interrater reliability (mean correlation .85).…”