A Short Functional Survey Is Responsive to Changes in Functional Status in Vulnerable Older People

Abstract

OBJECTIVES: 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. DESIGN: Longitudinal evaluation with mean follow‐up of 11 months. SETTING: Two managed‐care organizations in the United States. PARTICIPANTS: 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. MEASURES: 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 (κ=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). CONCLUSION: The short functional status survey is an efficient way to detect changes in functional status in vulnerable older populations for clinical and research purposes.