Predictive validity of the functional independence and difficulty scale in community-dwelling Japanese older adults.
Takashi Saito, Nobuko Matsui, Shuichiro Watanabe
PMID 28603371WHAT IT FOUND
In community-dwelling Japanese older adults who were independent in basic activities, lower scores on the Functional Independence and Difficulty Scale predicted future decline in instrumental activities and multiple falls.
The Barthel Index did not predict these outcomes.
Key findings
01Baseline Functional Independence and Difficulty Scale scores independently predicted subsequent decline in instrumental self-maintenance and multiple falls.
02The Barthel Index showed no statistical evidence of association with the adverse outcomes of instrumental activities of daily living decline or multiple falls.
03Participants who experienced adverse events had significantly lower baseline Functional Independence and Difficulty Scale scores compared to those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used convenience sampling from a single rural district, resulting in a small sample size (n=140) and a distribution of baseline scores biased toward higher function. Fall data were collected via retrospective recall in a postal survey, which is less accurate than prospective monitoring and may lead to underreporting. The analysis did not adjust for potential confounders such as walking ability, cognitive function, or past history of falls. The results cannot be generalized to other adverse outcomes such as institutionalization, healthcare utilization, or death.
Declared interests
The study was supported by the Univers Foundation (grant number 15-02-144).
The easy way to misread this
Do not assume the FIDS is superior to the Barthel Index for all populations. The study sample consisted entirely of older adults who were already independent in basic activities and had very high baseline scores on both scales. The FIDS may not add predictive value for individuals with established dependency in basic activities of daily living.