[The dependence medical index (DMI): validation and comparison with the activity daily living and the instrumental activity daily living].

AIM: The aim of this study was the validation of the dependence medical index (DMI), a disability medical assessment tool in the elderly.

METHODS

Study sample included 1054 subjects aged 65 and over, consecutively admitted to the University Department of Geriatric Medicine of Turin, Italy. A total of 356 of these subjects was classified as dependent to activity of daily living (ADL) and instrumental activity of daily living (IADL) scales. Some conditions causing medical dependence were detected, such as strength and/or motility impairment, incontinence, pressure sores, disturbances in speech and communication, decline in sight and/or hearing, terminal illness (death expected within 6 months), need for multiple and complex therapies, episodic disorientation, dizziness with tendency to fall, use of the wheel-chair. The relationship between dependence and the DMI was studied by discriminant analysis. A scale was created using the discriminant scores of each 15 medical indications for disability.

RESULTS

The discriminant model of DMI was validated by cross-validation statistical method: its application permitted to classify correctly 73.1% of the sample. The DMI permitted to classify the dependent subjects in variable percentages: from 67% (DMI score > or =1) to 90% (DMI score > or =7). The best ratio between specificity and sensibility was for score 4 to DMI.

CONCLUSION

The conclusion is drawn that DMI can be used to detect and evaluate the disability for medical reasons in elderly people.