Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review

Buurman, Bianca M.; Munster, Barbara C. Van; Korevaar, Johanna C.; Haan, Rob J. de; Rooij, Sophia E. de

doi:10.1016/j.jclinepi.2010.07.005

Cited by 111 publications

(96 citation statements)

References 45 publications

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“…It has been demonstrated that several studies used the Katz Index to assess ADL directly by patients or by proxies (informants) (25,27) . The reliability of the scale to assess ADL was synthetized in a review published in 2008 (22) , and the cut-off points for the Katz Index to be considered as indicative of functional decline (27) were demonstrated in www.ee.usp.br/reeusp…”

Section: Discussionmentioning

confidence: 99%

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

Ferretti-Rebustini

Balbinotti

Jacob‐Filho

et al. 2015

Rev. esc. enferm. USP

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Objective:To analyze the evidences of construct validity of the Katz Index for the retrospective assessment of activities of daily living (ADL) by informants, to assist neuropathological studies in the elderly. Method: A cross-sectional study analyzed the functional ability of ADL measure by the Katz Index, of 650 cases randomly selected from the Brazilian Brain Bank of the Ageing Brain Study Group (BBBABSG) database. Sample was divided in two subsamples for the analysis (N=325, each) and then stratified according to cognitive decline assessed by the Clinical Dementia Rating Scale (CDR). Factor analyses with calculations of internal consistency and invariance were performed. Results: Factor analysis evidenced a unidimensional instrument with optimal internal consistency, in all subgroups. Goodness of fit indices were obtained after two treatments of covariance, indicating adequacy of the scale for assessing ADL by informants. The scale is invariant to cognitive decline meaning that it can be used for subjects with or without cognitive impairment. Conclusion: Katz Index is valid for the retrospective assessment of basic ADL by informants, with optimal reliability.

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Section: Discussionmentioning

confidence: 99%

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

Ferretti-Rebustini

Balbinotti

Jacob‐Filho

et al. 2015

Rev. esc. enferm. USP

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“…The range of the sum score was 0-8, and the higher the score the greater the abilities [14,15]. The sum score was then dichotomized with a sum score of 8 indicating complete independency and a sum score <8 indicating disability in one or more of the items [23]. The examination protocol included medical history and information from a family carer, testing of cognitive function (a comprehensive battery), physical examination and a psychiatric evaluation with a primary emphasis on depression.…”

Section: Methodsmentioning

confidence: 99%

Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease

Hesseberg

Bentzen

Ranhoff

et al. 2013

Dement Geriatr Cogn Disord

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Background/Aims: The aim is toexamine disability in instrumental activities of daily living (IADL) in elderly persons with mild cognitive impairment (MCI) and Alzheimer‘s disease (AD), further to identify items of IADL which separate the two conditions and to explore potential gender differences. Methods: A cross-sectional study of 729 patients aged ≥65 years recruited from outpatient memory clinics. Multiple logistic regression analysis was used in the main analysis to explore the association between IADL and diagnosis. Results and Conclusions: We found an association between IADL and diagnosis, and a difference in the proportion of disability in IADL in patients with MCI and AD, i.e. 66 and 88%, respectively. Six of the 8 items revealed differences in the proportions of patients with IADL disability among MCI and AD. No substantial gender differences were found, except for laundry.

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“…Exclusion criteria were (1) hospital length of stay (LOS) of 2 days or less (n = 108), (b) healthcare-associated pneumonia [either from a residential facility or recent hospitalization in the last 14 days) (n = 92), (c) data missing during matching process (n = 77), or (d) deceased in hospital (n = 31). Functional decline was assessed using the Katz Activities of Daily Living (ADL) Index which is the most common measurement of activities of daily living functioning in hospitalized older medical patients [18]. A score of 0 represents total dependence and 6 represents total independence.…”

Section: Study Subjectsmentioning

confidence: 99%

Effects of Hospital-Based Physical Therapy on Hospital Discharge Outcomes among Hospitalized Older Adults with Community-Acquired Pneumonia and DecliningPhysical Function

Kim¹,

Lee²,

Han³

et al. 2015

Aging and disease

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To examine whether hospital-based physical therapy is associated with functional changes and early hospital readmission among hospitalized older adults with community-acquired pneumonia and declining physical function. Study design was a retrospective observation study. Participants were community-dwelling older adults admitted to medicine floor for community-acquired pneumonia (n = 1,058). Their physical function using Katz activities of daily living (ADL) Index declined between hospital admission and 48 hours since hospital admission (Katz ADL Index 6→5). The intervention group was those receiving physical therapy for ≥ 0.5 hour/day. Outcomes were Katz ADL Index at hospital discharge and all-cause 30-day hospital readmission rate. The intervention and control groups did not differ in the Katz ADL Index at hospital discharge (p = 0.11). All-cause 30-day hospital readmission rate was lower in the intervention than in control groups (OR = 0.65, p = 0.02). Hospital-based physical therapy has the benefits toward reducing 30-day hospital readmission rate of acutely ill older adults with community-acquired pneumonia and declining physical function.Key words: hospitalization, patient outcome assessment, physical therapy, pneumonia Functional decline in older adults is common and occurs in up to one-third of recently hospitalized older adults [1]. The hospital environment accelerates the reduction of functional reserve implicated factors include forced immobilization, disorientation due to unfamiliar hospital environments, and frequent orders not to eat by mouth [2][3][4][5][6]. In fact, hospitalized older adults spend more than 70% of their time lying in bed due to acute medical conditions, despite having the ability to walk [4].Functional decline during or after hospitalization is associated with adverse health outcomes, prolonged hospital stays due to more frequent occurrences of hospital complications, such as delirium; and more frequent episodes of early hospital readmissions and even higher long-term mortality rate [7][8][9][10][11][12].

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Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review

Cited by 111 publications

References 45 publications

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

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

Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease

Effects of Hospital-Based Physical Therapy on Hospital Discharge Outcomes among Hospitalized Older Adults with Community-Acquired Pneumonia and DecliningPhysical Function

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