A short functional survey is responsive to changes in functional status in vulnerable older people.
OBJECTIVE
To investigate whether an abbreviated five-item functional status survey consisting of five activities of daily living (ADLs) reflects changes measured over time in a full 12-item functional status survey.


METHODS
Longitudinal evaluation with mean follow-up of 11 months.


METHODS
Two managed-care organizations in the United States.


METHODS
Four hundred twenty community-dwelling older people at moderate to high risk of death and functional decline enrolled in the Assessing Care of Vulnerable Elders (ACOVE) observational study.


METHODS
Number of ADL abilities according to the short (range 0-5) and full functional status surveys (range 0-12); change in function as defined according to a 1-point change in short score and 1- to 2-point change in full survey scores.


RESULTS
Changes in short functional status survey scores were highly correlated to changes in long survey scores (correlation coefficient=0.88). On average, a 1-point change in the short survey score was associated with a 1.4-point change on the long survey score (P<.001). The short survey correctly classified 93% of those who declined according to the long survey, adjusting for chance agreement (kappa=0.82) and was responsive to decline in function (sensitivity 82-94%, specificity 94-97%, and area under the receiver operating curve 0.91-0.93 for 1- to 2-point decreases in full survey ADL counts).


CONCLUSIONS
The short functional status survey is an efficient way to detect changes in functional status in vulnerable older populations for clinical and research purposes.
Min
Lillian C
LC
Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA. lmin@mednet.ucla.edu
Wenger
Neil S
NS
Reuben
David B
DB
Saliba
Debra
D
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D035862:Vulnerable Populations
J Clin Epidemiol. 1992 Dec;45(12):1341-5
1460470
J Am Geriatr Soc. 1998 Feb;46(2):193-7
9475448
JAMA. 2003 May 14;289(18):2387-92
12746362
J Am Geriatr Soc. 2001 Dec;49(12):1691-9
11844005
Arch Intern Med. 1987 Mar;147(3):484-8
3827424
Ann Intern Med. 2003 Nov 4;139(9):740-7
14597458
J Chronic Dis. 1986;39(11):897-906
2947907
J Am Geriatr Soc. 2007 Dec;55(12):2041-4
17971138
J Clin Epidemiol. 2000 Mar 1;53(3):257-65
10760635
Cancer. 2007 Feb 15;109(4):802-10
17219443
Mayo Clin Proc. 2002 Jun;77(6):561-71
12059127
Ann Intern Med. 1991 Mar 15;114(6):451-4
1825267
Dis Manag. 2004 Winter;7(4):267-74
15671784
Br J Gen Pract. 2007 Feb;57(535):144-51
17263931
Med Care. 1981 May;19(5):489-97
6785540
Am J Public Health. 1991 Apr;81(4):443-7
2003621
J Gen Intern Med. 2004 Oct;19(10):1027-33
15482555
J Clin Epidemiol. 1989;42(5):403-8
2659745
J Am Geriatr Soc. 2006 Mar;54(3):507-11
16551321
J Gerontol A Biol Sci Med Sci. 2000 Dec;55(12):M750-6
11129398
J Am Geriatr Soc. 2008 Jan;56(1):8-15
18184202
J Am Geriatr Soc. 2003 Apr;51(4):492-8
12657068
J Am Geriatr Soc. 2007 Nov;55(11):1705-11
17979894
J Am Geriatr Soc. 2003 Jan;51(1):139-40
12534867
Am J Med. 1992 Dec;93(6):663-9
1466363
J Gen Intern Med. 2001 Nov;16(11):728-36
11722685