Background: The Activities of Daily Living score (ADL) is a widely used index to establish the degree of independence from any help in everyday life situations. Measuring the ADL accurately is time-consuming and costly. This paper presents a framework to approximate the ADL via variables usually collected in standard geriatric assessments. We showed that the selected variables serve as good indicators in explaining the physical disabilities of older and frail patients.
Methods: Our sample included information from a geriatric assessment of 326 patients aged between 64 and 99 years in a hospital in Tyrol, Austria. In addition to the ADL, 23 variables reflecting the physical and mental status of these patients were recorded during the assessment. We performed LASSO to determine which of these variables had the highest impact on explaining the ADL. Then, we used ROC analysis and logistic regression techniques to validate our model performance. Finally, we calculated cutoff-points for each of the selected variables, showing at which values the ADL falls below a certain threshold.
Results: Mobility, urinary incontinence, nutritional status and cognitive function were closest related to the ADL and, therefore, to a geriatric patient’s functional limitations. Jointly, the selected variables were able to predict neediness with high accuracy (AUC = 0.89 and 0.91, respectively). If a patient had a limitation in one of these variables, the probability of everyday life disability increased with a statistically significant factor between 2.4 (nutritional status, 95%-CI 1.5 – 3.9) and 15.1 (urinary incontinence, 95%-CI 3.6 – 63.4).
Conclusions: Our study highlighted the most important impairments of everyday live, facilitating a more efficient use of clinical resources which, in turn, allows for a more targeted treatment of geriatric patients. At the patient level, our approach enables early detection of functional limitations and timely indications of a possible need for assistance in everyday life.