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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Benchmarking functional status in older adults.

Paul Gerrard1, John Luce2, Jonathan F Bean2

  • 1Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Division of Physical Medicine and Rehabilitation, Department of Medicine, Newton Wellesley Hospital, Newton, MA.

Archives of Physical Medicine and Rehabilitation
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PubMed
Summary
This summary is machine-generated.

This study shows that functional status difficulties increase with age across physical and cognitive domains. Normative values from this 20-item index can help assess an individual

Keywords:
Factor analysis, statisticalGeriatric assessmentGeriatricsRehabilitation

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Area of Science:

  • Gerontology
  • Public Health
  • Health Measurement

Background:

  • Functional status is crucial for healthy aging.
  • Understanding age-related changes in functional domains is essential for targeted interventions.
  • Existing measures may not adequately capture the multi-domain nature of functional status in older adults.

Purpose of the Study:

  • To characterize age-related functional status difficulties across lower extremity, upper extremity, and cognitive/social domains.
  • To assess the construct validity of a novel 20-item functional status measure.
  • To establish normative benchmarks for functional status in community-dwelling older adults.

Main Methods:

  • Cross-sectional survey of 7968 community-dwelling U.S. adults aged 60 and older.
  • Confirmatory factor analysis was used to assess the model fit of a 20-item functional status measure.
  • Age-specific functional status benchmarks were developed using percentile curves.

Main Results:

  • The 20-item measure demonstrated good model fit as a 3-factor construct (RMSEA=.045, SRMSR=.052).
  • Functional difficulty scores showed a steady increase with age across all domains.
  • Cognitive/social function domains were less sensitive to age increases compared to extremity function domains.

Conclusions:

  • A 20-item functional status measure effectively captures difficulties across three key domains.
  • The developed index provides normative values for comparing patient functional status to a national sample.
  • This measure can aid in assessing and monitoring functional status in older adults.