hacks_impairment_index: HACKS Impairment Index (HII)

In cliot: Clinical Indices and Outcomes Tools

HACKS Impairment Index (HII)

Description

Calculates the HACKS Impairment Index score to screen for frailty and predict the risk of institutionalization and mortality in older adults. The acronym HACKS stands for: Hearing loss, ADL/IADL impairment, Cognitive impairment, K(C)omorbidity, and Slow gait (though specific items have evolved in validation studies to the 6 used here: Gait Speed, SPPB/Physical Performance, Cognition, Incontinence, ADL, IADL).

Usage

hacks_impairment_index(gait_speed_lt_0_8, physical_performance_lt_10,
                       mmse_lt_26, incontinence, adl_impairment,
                       iadl_impairment)

Arguments

gait_speed_lt_0_8	Numeric (0 or 1). Gait speed < 0.8 m/s. (1 = Yes, +1 point).
physical_performance_lt_10	Numeric (0 or 1). Short Physical Performance Battery (SPPB) score < 10. (1 = Yes, +1 point).
mmse_lt_26	Numeric (0 or 1). MMSE score < 26. (1 = Yes, +1 point).
incontinence	Numeric (0 or 1). Presence of urinary incontinence. (1 = Yes, +1 point).
adl_impairment	Numeric (0 or 1). Impairment in at least one Activity of Daily Living (ADL). (1 = Yes, +1 point).
iadl_impairment	Numeric (0 or 1). Impairment in at least one Instrumental Activity of Daily Living (IADL). (1 = Yes, +1 point).

Value

A list containing:

HII_Score	The calculated total score (Range 0-6).
Impairment_Level	Classification (No, Mild, Severe Impairment).
Institutionalization_Risk	Estimated risk category.

References

Jankovic D, et al. The HACKS impairment index: a simple screening tool for frailty and adverse outcomes in older adults. (Contextual reference based on tool description).

Examples

# Example 1: Severe Impairment
# Slow gait (+1), SPPB<10 (+1), MMSE<26 (+1), ADL (+1)
# Score = 4
hacks_impairment_index(1, 1, 1, 0, 1, 0)

# Example 2: No Impairment
# All normal
hacks_impairment_index(0, 0, 0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.