Clinical utility of the functional independence measure for assessment of patients with Alzheimer's disease and vascular dementia

Psychogeriatrics. 2013 Dec;13(4):199-205. doi: 10.1111/psyg.12012. Epub 2013 Oct 28.

Abstract

Aim: The aim of this study was to investigate the clinical utility of the Functional Independence Measure (FIM), and especially FIM-Cognition (FIM-C) scores, in patients with Alzheimer's disease (AD) and vascular dementia (VaD), and to determine the influence of behavioural and psychological symptoms of dementia (BPSD) on FIM-C scores.

Methods: This was a cross-sectional survey of 37 AD and 40 VaD patients. Cognitive function was assessed with the Cognitive Abilities Screening Instrument. Activities of daily living were evaluated with the FIM and the Barthel Index. BPSD were assessed with the Behavioural Pathology in Alzheimer's Disease Frequency Weighted Severity Scale.

Results: For both groups, Spearman's correlations were found between FIM-Motor and Barthel Index scores and between FIM-C and Mini Mental State Examination scores. Each FIM-C subscore was correlated with Cognitive Abilities Screening Instrument scores in both groups, except for the FIM-C Social interaction subscore in VaD. VaD patients showing Activity Disturbance and Aggressiveness on the Behavioural Pathology in Alzheimer's Disease Frequency Weighted Severity Scale had significantly lower FIM-C Memory and Social interaction subscores than those without BPSD.

Conclusion: The results suggest that the FIM-Motor and FIM-C scales are useful measures of physical and cognitive disabilities in patients with AD and VaD. The FIM-C profile of AD may reflect global cognitive function, while that of VaD may be more influenced by BPSD.

Keywords: Alzheimer's disease; activities of daily living; behavioural symptoms; dementia; vascular dementia.

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology
  • Behavioral Symptoms / complications
  • Behavioral Symptoms / diagnosis
  • Behavioral Symptoms / psychology
  • Cognition Disorders / complications
  • Cognition Disorders / diagnosis
  • Cognition Disorders / psychology
  • Cross-Sectional Studies
  • Dementia, Vascular / complications
  • Dementia, Vascular / diagnosis*
  • Dementia, Vascular / psychology
  • Female
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Neuropsychological Tests / standards
  • Neuropsychological Tests / statistics & numerical data*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Reproducibility of Results