THE COMPREHENSIVE ASSESSMENT OF COMMUNITY-DWELLING ELDERLY - WHY FUNCTIONAL STATUS IS NOT ENOUGH

The present study attempts to determine empirically the relationship o f measures of functional status to other domains common to geriatric a ssessment, and to ascertain whether functional status can substitute f or other domains of clinical assessment. A comprehensive research surv ey was administered in the home to a randomly selected population of 4 163 community residents aged 65 and over in the Duke EPESE, one of the four sites of the National Institute on Aging-funded Established Popu lations for Epidemiologic Studies of the Elderly. Sample members were predominantly black (55%), female (65%), between 65 and 74 years of ag e (61%), and lived in five contiguous counties within the state of Nor th Carolina. Measurements included three measures of functional status ranging from basic activities of daily living (ADL) to strenuous mobi lity items, and summary measures of cognition, depression, and overall physical health. The three functional status measures were inter-corr elated, However, with the exception of cognitive status and performanc e of instrumental ADL, the functional status measures failed to show a clinically significant relationship with the domains of cognition, de pression, or overall physical health status. Furthermore, even among t hose sample members impaired in all three domains, 8% could still perf orm strenuous activities, and over 50% could still perform the basic a ctivities of daily living. The data show that functional status measur es are not necessarily indicative of an elder's mental or physical hea lth. Each domain of assessment contributes unique data, and no one are a can fully substitute for another: