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Overestimated functional dependency in older patients: Can we blame gender difference, unneeded assistance or assessment tools?

Publication date: May–June 2020

Source: Archives of Gerontology and Geriatrics, Volume 88

Author(s): Doha Rasheedy, Rania Mohammed Abou-Hashem

Abstract
Introduction

The population is aging in Egypt and hence functional limitation is increasing. Thus finding the best measures for its detection is mandated.

Objectives

The aim of this study was to assess whether Katz ADL (activities of daily living) and Lawton IADL (instrumental activities of daily living) were suitable measures to represent the functional abilities of older Egyptians of both genders during hospital admission and to determine the dimensionality of both tools.

Methods

Functional status was assessed during hospital admission as a part of the comprehensive geriatric assessment for 786 older patients (aged 60 years and older). 150 of them were randomly interviewed to collect data regarding the difficulty during each task of Katz ADL and Lawton IADL performance, unnecessary and unmet needed assistance, barriers to get needed assistance and the type of care providers.

Results

The prevalence of ADL and IADL dependency was 61.80 % and 85.87 %, respectively. Functional limitation in both scales was found to be significantly associated with increasing age, marital status other than married, cognitive impairment. Both scales showed a bi-dimensional factor structure, removing continence from Katz ADL resulted in a uni-dimensional scale. Females were more dependent than males in all tasks except household tasks of IADL.

Conclusions

Katz ADL and Lawton IADL did not capture the actual dependency level among older Egyptians. The household tasks in Lawton IADL and continence in Katz ADL mislabeled dependency in the studied sample.

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Posted in: Journal Article Abstracts on 02/09/2020 | Link to this post on IFP |
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