Determining optimal Barthel Index cutoff scores for predicting Longshi Scale grades across age groups in stroke patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The Barthel Index (BI) is a standard, widely used measure of dependence in activities of daily living (ADL), particularly in stroke care. The Longshi Scale (LS) offers a simpler, more user-friendly alternative; however, it lacks a validated, age-stratified mapping to BI scores. This gap limits consistent outcome interpretation and application. Objective: This study aims to establish and validate a standardized, age-stratified concordance between BI scores and LS grades, thereby providing a practical conversion tool for clinical and research settings. Method: In a multi-center study of 16,412 stroke inpatients (3 months post-stroke), BI scores and LS grades were analyzed across age groups: <60 years (n = 12,662), 60-79 years (n = 2,596), and ≥80 years (n = 1,154). Sensitivity (correct identification) and specificity (correct exclusion), along with receiver operating characteristic (ROC) curves were used to determine optimal BI cutoff points for each LS grade. Spearman correlation and the Kruskal-Wallis test were applied across age groups. Results: < 0.001). Correlations remained strongest at severe disability levels (LS grades 5-6) across age groups (r = -0.60 to -0.65). AUC analysis demonstrated excellent discriminative ability, particularly for the mildest (LS 1) and most severe (LS 6) disability levels (AUC >0.95). Conclusion: The study provides age-stratified BI cutoff values to guide resource allocation, emphasizing the need to prioritize care for individuals aged ≥80 years with BI scores below 5.
Source: Frontiers in Aging
Institutions: Shenzhen University, Shenzhen Second People's Hospital
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,077
OpenAlex ID: W7128440774