What is the Katz ADL index?

A measure of independence in six basic activities of daily living: bathing, dressing, toileting, transferring from bed to chair, continence and feeding. Sidney Katz and colleagues published it in 1963, based on how children develop these abilities and how older people lose them in the reverse order.

How is the Katz index scored?

In the common version, each activity scores 1 if the person does it without help and 0 if not, for a total of 0 to 6. A score of 6 means full function, 4 moderate impairment and 2 or less severe impairment. This calculator also allows 0.5 for partial help, as many clinicians do.

What is the Katz index used for?

It helps describe the help an older or disabled person needs, plan home care or a nursing home admission, and follow changes after an illness or hospital stay.

What are the limits of the Katz index?

It covers only basic self-care, so it misses early difficulties that the Lawton IADL scale detects, and it does not measure walking, cognition or mood. Two people with the same score can need very different help.

Katz ADL index calculator: score from 0 to 6

This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.

The basic activities of daily living

The Katz index, published by Sidney Katz and colleagues in 1963, looks at the six most basic activities of self-care. Katz noticed that older people recovering from a hip fracture regained these abilities in a fixed order, the reverse of the order in which children acquire them. Losing them, by contrast, often starts with bathing and ends with feeding.

The six activities

Activity	Independent means
bathing	bathes alone, or needs help with only one part of the body
dressing	gets clothes and dresses without help, except tying shoes
toileting	goes to the toilet, cleans and arranges clothes without help
transferring	moves in and out of bed or a chair without help; aids such as a cane are allowed
continence	controls bladder and bowel completely
feeding	gets food from plate to mouth without help; food may be prepared by someone else

Scoring

In the most common version, each activity counts 1 point if the person does it without supervision or help, and 0 otherwise. Many clinicians, including in France, also allow 0.5 for partial help, which this calculator supports:

Score	Function
6	full function
4	moderate impairment
2 or less	severe functional impairment

The original index used letters from A, independent in all six, to G, dependent in all six.

Example

An older woman who needs help getting in and out of the bath but manages everything else scores 5.5 with partial help counted as 0.5, or 5 with the yes/no version: moderate impairment. A shower seat and grab bars might make her independent again.

Using the score

Assess what the person does, not what they could do.
Repeat the score after an illness or hospital stay: losing ADL in hospital is common and often reversible with early mobilization.
Combine it with the Lawton IADL scale, a cognitive test and an assessment of walking and mood for a complete picture.

Limits

The Katz index is simple and fast, but it is not very sensitive to small changes and has a ceiling effect: most people living at home score 6. It does not measure walking distance, falls or cognition.

Results are estimates provided for information purposes. They do not replace professional advice.

Katz ADL: can this person manage basic self-care?