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Updated: Jun 23, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
[FUNCTIONAL INDEPENDENCE MEASURE SCALE SCORES IN SEVERELY DEPENDENT OLDER ADULTS UPON REHABILITATION COMPLETION
Danielle Ann Peleg1, Dan Justo2
1Internal Medicine B, Meir Medical Center, Kfar-Saba, Israel.
Introduction:
: Functional Independence Measure (FIM) is a scale used to evaluate functional status during rehabilitation. The associations between FIM scale scores upon stroke rehabilitation completion and functional status of older adults according to the Israeli Ministry of Health (MOH) guidelines has never been studied until now.
Aims:
To study the association between FIM scale scores upon stroke rehabilitation completion and functional status of older adults according to the Israeli MOH guidelines.
Methods:
A retrospective cross-sectional study was conducted at the Geriatric Rehabilitation department in Sheba Medical Center. Medical charts of older adults (age ≥65 years) admitted for rehabilitation during 2018-2020 following stroke were studied. Age, gender, total FIM score upon rehabilitation completion, functional status upon rehabilitation completion according to the Israeli MOH guidelines and moving to a nursing-home were documented.
Results:
The cohort included 119 older adults: 63 (52.9%) males; mean age was 80.5±7.6 years. Most older adults were severely dependent upon rehabilitation completion (n=97/119, 81.5%) and 16 (16.5%) of whom moved to a nursing-home. Median total FIM scores upon rehabilitation completion was 109 (IQR: 106-116) in mildly dependent older adults, 69 (IQR: 48-84) in severely dependent community-dwelling older adults, and 34 (IQR: 25-45) in severely dependent nursing-home residents (p<0.001). Total FIM score of 100 (or less) had the highest sensitivity (93.8%) and specificity (95.5%) in differentiating between mildly dependent and severely dependent older adults. Binary logistic regression showed a significant association between being severely dependent and total FIM scores upon stroke rehabilitation completion - adjusted for age and gender (OR 0.53, 95% CI 0.30-0.92, p=0.025).
Conclusions:
These findings may assist Israeli geriatricians who use the FIM scale to define the functional status of older adults upon stroke rehabilitation completion.
