Dapp U, Minder CE, Anders J, Golgert S, von Renteln-Kruse W
BMC Geriatr 2014;14:141
Publication date: December 19, 2014
The detection of functional decline in elderly persons is not an easy task. Dapp et al. suggest that the self-reporting Functional Ability Index (FA index) is suitable to screen functional competence in senior citizens in the community setting.
This index is based on both resources and risks/functional restrictions which precede ADL limitations. Its prognostic validity was investigated in the Longitudinal Urban Cohort Ageing Study (LUCAS). Since 2001, the FA index was tested in the LUCAS cohort without any ADL restrictions at baseline (n = 1,679) and followed up by repeated questionnaires in Hamburg, Germany.
Using the index, 1022 LUCAS participants were initially classified as robust (60.9%), 220 as post-robust (13.1%), 172 as pre-frail (10.2%) and 265 as frail (15.8%). This classification correlated with self-reported health, chronic pain and depressive mood (rank correlations 0.42, 0.26, 0.21; all P< 0.0001).
Survival analyses showed significant differences between these classes as determined by the FA index: the initially robust survived longest, the frail shortest (P < 0.0001). Analyses of the time to need of nursing care revealed similar results. Significant differences persisted after adjustment for age, sex and self-reported health.
The FA index predicted change in functional status, future need of nursing care and mortality in an unselected population of community-dwelling seniors.