Abstract

Background: The aim of this study was to determine whether or not the Barthel Index (BI) is an adequate basic assessment tool to identify a risk group in people aged 70+ living at home whose capacity for independent living is at risk.
Methods: A multidimensional nursing assessment was performed on 344 people aged 70+ living at home in Austria, using the Barthel Index to rate activities of daily living and other functional health indicators. Instead of categorizing the total BI scores (TS) into four groups, the sample was divided into two groups: independent older people (TS 85–100 pts.) and non-independent older people (TS 0–80 pts.). The division into two groups is based on the assumption that independent living at home is virtually impossible with a TC of 0–80 pts. However, people aged 70+ who are completely independent or only partly in need of care are certainly able to live an independent life. The strength of the association between an independent or non-independent lifestyle and functional health impairments was measured by means of odds ratios with a 95% confidence interval.
Results: The BI classified 76.8% of the 70+-year-olds (n=265) as independent. In comparison to the independent group, the non-independent group (n=79, 22.8%) had significantly more health-related problems in all assessed dimensions (e.g. TS of the IADL Index [0–7 pts.] (OR 1.4, 95% CI [1.31, 1.53]), dissatisfaction with general health status (OR 5.1, 95% CI [2.99, 8.71]), and falls during the last year (OR 2.9, 95% CI [1.69, 4.88]).
Conclusion: Categorization of the BI was able to identify a risk group and can provide a solid basis for target-group-specific support planning in the field of home-based primary care in Austria under due consideration of biopsychosocial conditions.