PROSPECTIVE VALUE OF SELF-REPORT AND PERFORMANCE-BASED TESTS OF FUNCTIONAL STATUS FOR 18-MONTH OUTCOMES IN ELDERLY PATIENTS

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