The Katz Index of Independence in Activities of Daily Living (ADL) is the foundational tool in geriatrics for evaluating an older adult's functional capacity.
Beyond Medical Diagnoses
In geriatric medicine, knowing a patient's medical diagnoses (e.g., heart failure, osteoarthritis) is less important than knowing how those diseases affect their daily life. A patient might have severe heart failure but can still bathe and feed themselves. Conversely, a patient with mild dementia might be physically healthy but completely unable to dress themselves, requiring 24/7 care.
The Six Domains
The Katz Index rigidly evaluates the six core physiological necessities of independent living.
- Bathing: Getting into a tub and washing all parts of the body.
- Dressing: Retrieving clothes from a closet and putting them on.
- Toileting: Getting to the toilet and cleaning oneself.
- Transferring: Moving from a bed to a chair.
- Continence: Complete control of bowels and bladder.
- Feeding: Getting food from a plate into the mouth.
Sum of points (0-1) across 6 domains: Bathing, Dressing, Toileting, Transferring, Continence, and Feeding.
A score of 6 indicates full independence. A score of 0 indicates complete dependence, necessitating total care.