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LETTER TO THE EDITOR
Year : 2014  |  Volume : 58  |  Issue : 4  |  Page : 293-294  

Author's Reply to 155_14 and 233_14: Functional disability among elderly persons in a rural area of Haryana


1 Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication5-Dec-2014

Correspondence Address:
Sanjeev Kumar Gupta
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.146310

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How to cite this article:
Gupta P, Mani K, Rai SK, Nongkynrih B, Gupta SK. Author's Reply to 155_14 and 233_14: Functional disability among elderly persons in a rural area of Haryana . Indian J Public Health 2014;58:293-4

How to cite this URL:
Gupta P, Mani K, Rai SK, Nongkynrih B, Gupta SK. Author's Reply to 155_14 and 233_14: Functional disability among elderly persons in a rural area of Haryana . Indian J Public Health [serial online] 2014 [cited 2020 Sep 30];58:293-4. Available from: http://www.ijph.in/text.asp?2014/58/4/293/146310

Sir,

We appreciate comments on our article, "Functional Disability among Elderly Persons in a Rural Area of Haryana." [1]

As mentioned, in this study we have used Barthel Index for estimating the functional disability among elderly persons. The Barthel Index, which was introduced in 1965 by Mahoney and Barthel, was developed as a means of measuring the severity of disability in people whose disease interfered with independent movement of the limbs. [2] The activities of daily living (ADL) covered by the Barthel Index are generally representative of the overall functional abilities of disabled people. The activities used in the index have been selected because of their perceived social importance and physically disabling conditions. Literature shows that Barthel Index has been widely tested for validity, and was found to be comparable with other measurements of functional ability. [3] Since the objective of our study was to assess the prevalence of functional disability, Barthel Index was chosen as a suitable tool for the study.

However, we agree that Barthel Index has certain limitations since it measures only the physical activities and does not include the qualitative aspects of daily activities. Besides, the assessment of daily activities may vary depending on the investigator's familiarity and ability to elicit cooperation of the respondent.

On the other hand, Everyday Abilities Scale for India (EASI) was developed, validated and used in a rural population of Ballabgarh, Haryana, North India to assess the prevalence of dementia among the elderly persons. [4] It included activities that are likely to be affected by cognitive impairment, whereas important daily activities such as mobility, bathing and feeding are not part of EASI.

Katz Scale, on the other hand, is a widely accepted scale which is used in elderly persons. [5] It assess the six basic functions that are, bathing, dressing, toileting, transferring, continence and feeding. These activities are important for nursing care of the patient, and for assessing the progress of the patient from dependence to an independent state. The Katz ADL Index assesses basic ADL. It does not assess more advanced ADL. Although the Katz ADL Index is sensitive to changes in declining health status, it is limited in its ability to measure small increments of change seen in the rehabilitation of elderly. While comparing the Katz scale with Barthel Index, we can see that the activities in Barthel Index are similar, and in addition it can also assess locomotor activities such as mobility, climbing stairs, etc.

Considering the merits and demerits of these scales, we decided to use the Barthel Index despite its limitations. There is a scope for utilizing a mix of these scales in order to address the physical, social and cognitive areas of assessment, though that may require further validation and reliability studies.

 
   References Top

1.
Gupta P, Mani K, Rai SK, Nongkynrih B, Gupta SK. Functional disability among elderly persons in a rural area of Haryana. Indian J Public Health 2014;58:11-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Wylie CM, White BK. A measure of disability. Arch Environ Health 1964;8:834-9.  Back to cited text no. 2
[PUBMED]    
3.
Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: Measurement by PULSES profile and the Barthel Index. Arch Phys Med Rehabil 1979;60:145-54.  Back to cited text no. 3
[PUBMED]    
4.
Fillenbaum GG, Chandra V, Ganguli M, Pandav R, Gilby JE, Seaberg EC, et al. Development of an activities of daily living scale to screen for dementia in an illiterate rural older population in India. Age Ageing 1999;28: 161-8.  Back to cited text no. 4
    
5.
Katz Index of independence in activities of daily living. Available from: http://www.consultgerirn.org/uploads/File/trythis/try_this_2.pdf. [Last accessed on 2014 Jul 03].  Back to cited text no. 5
    




 

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