Sidney Katz

A Measure of Primary Sociobiological Functions

The Index of Independence in Activities of Daily Living (Index of ADL) is a scale whose grades reflect profiles of behavioral levels of six sociobiological functions, namely, bathing, dressing, toileting, transfer, continence, and feeding. Its hierarchical nature makes it possible to rank the overall functional status of people in an ordered manner, to make comparisons among them as individuals or groups, and to detect changes over time. Developmental studies have encompassed children as well as adults, the mentally retarded as well as physically disabled, and noninstitutionalized as well as institutionalized people. In view of relationships to behavior of primitive societies and parallelisms between the order of index functions and patterns of child growth and development, the Index of ADL appears to be based on functions of sociobiological primacy. This concept is supported by twenty years of methodological and applied observations. The Index has been used to produce predictive information about chronic conditions and to evaluate the benefits of long-term services. It has been used in profiled measures of severity of illness. As a screening measure and survey measure, it has contributed information about health needs and outcomes which is useful for management, planning, policy making, research, and teaching.

Active life expectancy.

This study was designed to demonstrate the feasibility of forecasting functional health for the elderly. Using life-table techniques, we analyzed the expected remaining years of functional well-being, in terms of the activities of daily living, for noninstitutionalized elderly people living in Massachusetts in 1974. The expected years, or active life expectancy, showed a decrease, from 10 years for those aged 65 to 70 years to 2.9 for those 85 or older. Active life expectancy was shorter for the poor than for others, and women had a longer average duration of expected dependence than men. The measure of active life expectancy provides important information about health at a given population level, in terms other than death. This information can be used for actuarial purposes in planning and policy making. It is also useful in identifying high-risk populations for which preventive health care and medical care can compress morbidity during the last years of life.

RISK OF FUNCTIONAL DECLINE AMONG WELL ELDERS

Active lifestyles may delay the onset of the functional consequences of chronic disease, potentially increasing active life expectancy. We analyzed the Longitudinal Study of Aging (LSOA) to test the hypothesis that elders participation in an active lifestyle prevents loss of function. Focusing on the cohort aged 70-74 who reported being able to carry 25 lb, walk 1/4 mile, climb 10 steps and do heavy housework without help and without difficulty at baseline, decline was defined as no longer being able to perform these tasks independently and without difficulty 2 years later. Using multivariate logistic regression, results reveal that those who did not report regularly exercising or walking a mile were 1.5 times more likely to decline than those who did, controlling for reported medical conditions and demographic factors. Similar findings (with different models) were observed for both men and women. Findings suggest the potential value of programs oriented toward the primary prevention of functional decline.

A prospective study of functional status among community elders.

A six-year prospective study provides estimates of functional status (independent, dependent, nursing home resident, or deceased) according to age, gender, and previous functional status for Caucasian elders initially living in the community. Half the cohort had sustained independence for the six years; of those dependent at the beginning, one-fourth to one-third regained independent function within 15 months, and one-fifth regained self-sufficiency within five years.

12. Index of ADL.

The Index of Activities of Daily Living (ADL) encompasses six basic human functions: bathing, dressing, toileting, transfer, continence, and feeding. It provides an objective method of classifying heterogeneous groups of people with chronic illnesses, disabilities and impairments, and of describing their health needs and outcomes.

Chronic-disease Classification in Evaluation of Medical Care Programs

For ideal classification of chronic disease in large populations, identification of the presence or absence of every chronic disease in every person would be desirable, as would knowledge of specific causes and pathogenesis, means to define cause, measure severity, and identify important milestones. The authors have approached the problems by analyzing advantages and disadvantages of certain aids to classification of chronic disease, namely, categorical disease classification, disability classification, and multiphasic screening. They describe a modified approach to classification, developed in conjunction with studies of the chronically ill and aged, which consists of establishing for each person a profile that includes principal diagnosis, disease status defined by chronic disease screening, and disability status based on comparable and systematic evaluation. A set of classes which combines the advantages of each of the separate approaches to chronic disease description is synthesized. An illustration of the use of this approach in describing the chronic disease status of one group is presented. The approach can be adapted to other populations and other purposes, and the authors suggest that it should be of particular use in large-scale population studies.

Results of long-term home nursing: The influence of disability☆

Abstract An experimental, controlled study of the effect of home nursing on patients discharged from a chronic disease rehabilitation hospital has demonstrated that, over a 2-yr period, mildly or moderately disabled patients benefit in terms of physical and mental function and by avoiding admission to nursing homes. Severely disabled patients, on the other hand, do not show results, but are influenced to make greater use of other health services.

Search for Illness Due to Adenovirus Type 4 Among College Dormitory Freshmen.

Summary A search was made for presence of infection due to adenovirus type 4 in dormitory freshmen of Case Inst. of Technology, Western Reserve Univ., and U.S. Military and Naval Academies. Antibody analyses revealed no instance of such infection in 126 students. Three students had rises in serum titers of complement-fixing antibodies against adenovirus type 4; however, none of the 3 had rises in serum titers of neutralizing antibodies against adenovirus types 1, 2, 3, 4, 5, 6, and 7. One student from the Naval Academy who had only a 1-tube rise in complement-fixing antibody developed a significant rise in neutralizing antibody against type 7 adenovirus.

Antihistamines and the Common Cold

ficial effects of Benadryl in the treatment of a group of patients with colds, he stated that in 10 percent of the patients the disease was aborted, while in 85 percent the course of the disease was shortened, and in 5 percent there was no effect. Within the next