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Correlation of the Index of Activities of Daily Living (Index of ADOH) with the Functional Independence Measure (FIM) in Older Adults

Sue S Spackman* and Bauer JG

Background: Index of Activities of Daily Oral Hygiene is correlated with Barthel Index, showing high discriminant capacity for dependency in manipulating oral self-care aids. Due to the reciprocation of disease, there is a need to correlate the Index of Daily Oral Hygiene with the Functional Independence Measure, a measure that integrates dentistry with other medical indices and the purpose of this study. Methods: For this cross-sectional study, a convenience sample of 73 nursing home residents, informed consents using the inclusion criterion of 65 years of age (VAWLA IRC, HS VA, PCC2001-121877) were obtained, and subjects were categorized into dentate and non-dentate groups. Attrition and post-hoc power calculations were reported. One accessor completed all assessments for the primary two assessment instruments, along with chart review for additional medical indices, and completion of resident oral self-care behavior questionnaire. Pearson r correlations (dentate group), confidence intervals using Fisher’s Norma transformation (p=0.05) and Spearman correlation (nondentate), rs correlation statistic with confidence interval, and t-statistic (p.05) were reported. Results: Significant correlations for dentate subject ADOH dependency was associated with FIM when decrements or dependencies were found in upper body functions: r = -0.35, CI -0.63 to 0.00 (p=0.05) to r = -0.049, CI -0.73 to -0.13 (p=0.01). For non-dentate subjects, ADOH dependency had a strong inverse relationship with ADL dependency: rs = -0.75, CI -0.93 to -0.73 (p=0.008) to rs = -0.093, CI -0.98 to -0.73 (p=0.0001). In non-dentate subjects, ADL was not associated with upper body strength and tasks involved in oral self-care behaviors for denture maintenance Conclusions: In dentate individuals, ADOH dependency is associated with functional decrements and significantly correlated with FIM dependency. In non-dentate individuals, ADOH dependency was not associated with FIM/ADL dependency. Thus, denture wearers can be dependent in FIM/ADL upper body function yet independent in maintaining denture, oral self-care behaviors.