T. Nikolaus et al., PROSPECTIVE VALUE OF SELF-REPORT AND PERFORMANCE-BASED TESTS OF FUNCTIONAL STATUS FOR 18-MONTH OUTCOMES IN ELDERLY PATIENTS, Aging, 8(4), 1996, pp. 271-276
To determine predictors of death, nursing home placement and hospital
admission, a prospective study was carried out in a university-affilia
ted geriatric hospital and a general practice. One hundred and thirty-
five patients consecutively admitted from home to the geriatric hospit
al and discharged home again (site 1), and 144 patients, aged 70 years
and over, of a general practice (site 2) were recruited for a compreh
ensive geriatric assessment program. At baseline, none was completely
dependent on others, or severely demented. At follow-up after 18 month
s, 46 subjects (17%) had died, 20 subjects (7%) had been institutional
ized, and 79 had been admitted to hospital (28%) in the interim. Univa
riate analysis demonstrated a significant association between Barthel
Activities of Daily Living (ADL), Lawton-Brody Instrumental Activities
of Daily Living (IADL), Mini-Mental State Examination (MMSE), Balance
and Gait Evaluation, Timed ''Up and Go'', Timed Test of Money Countin
g, Grip-Strength and Williams Board Test, and death as well as nursing
home placement. Barthel-ADL were significantly correlated with hospit
al admission. In a logistic regression analysis, Barthel-ADL were inde
pendent predictors for death; Barthei-ADL, Timed ''Up and Go'', Timed
Test of Money Counting, and Williams Board Test were independent predi
ctors for nursing home placement. No independent predictor was found f
or hospital admission. It is concluded that self-report and performanc
e-based measures of functional capabilities are useful instruments to
identify patients at risk for nursing home placement and death. Factor
s contributing to hospital admissions are other than those measured by
the applied tests. (C)1996, Editrice Kurtis