A short functional survey is responsive to changes in functional status in vulnerable older people

OBJECTIVES: To investigate whether abbreviated five-item functional status survey consisting Of five activities of daily living (ADLs) reflects changes measured over time ill a full 12-item functional Status survey. DESIGN: Longitudinal evaluation With mean follow-up of I I 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 statue surveys (range 0-12); change in function as defined according to a I-point change in short score and 1- to 2-point change in full survey scores. RESULTS: Changes ill 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 oil the long survey score (P<.001). The short survey correctly classified 933% 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 ADI. Counts). CONCLUSION: The short functional status survey is an efficient way to detect change,, in functional status in vulneaable older populations for clinical and research purposes.