FUNCTIONAL ASSESSMENT OF ELDERLY PATIENTS IN A GENERAL-PRACTICE

To evaluate functional disabilities in elderly patients, geriatric ass essment was performed in one general practice. Excluded from the study were patients with severe dementia and dependence. 178 patients were asked to participate and 144 accepted (mean age 78.7 +/- 5.8 years; nu mber of diagnoses 5.2 +/- 2.6; f = 95, m = 49). Mini-mental-status exa mination showed moderately but significantly lower (p < 0.05) cognitiv e capacity in the age groups of 80-84 years (n = 37, 24.56 +/- 4.90 po ints) and of 85 years and older (n = 30, 25.14 +/- 3.11 points), but n ot in the group of 75-79 years (n = 46, 26.70 +/- 3.90 points) compare d to the group of 70-74 years (n = 31, 27.65 +/- 2.59 points). Neither the Geriatric Depression Scale nor the Barthel-Index (activities of d aily living) showed significant differences between the age groups. Th e score of the instrumental activities of daily living (Lawton Index) was significantly lower (p < 0.05) in the age group 85 years and older (4.1 +/- 2.5 points) compared to the age group of 70-74 years (6.1 +/ - 2.4 points). Grip strength was significantly reduced (p < 0.01) in t he age group 85 years and older as well as motility and balance scores (Tinetti test; p < 0.05) compared to the group of 70-74 years (43.21 +/- 16.27 kp and 64.87 +/- 19.81 kp, resp., 19.3 +/- 6.6 and 23.1 +/- 5.9 points). No correlation was found between the results of functiona l assessment and number of contacts with the general practitioner in t he past year, number of prescribed drugs and number of diagnoses excep t for the depression test. There was a significant correlation between test score, number of contacts, and number of diagnoses (p < 0.05). F unctional assessment resulted in new diagnoses of urinary incontinence in 7 patients and of mobility disorders in 17 patients. Cognitive imp airment was suspected in 14 patients, depression in 2 patients. The st udy demonstrates the diagnostic value of Geriatric Assessment especial ly in detecting incontinence, dementia, depression, mobility disorders , and risk of falls. The need for ambulatory help to maintain independ ence can be evaluated. The assessment procedure is easy to learn, quic kly performed, and highly accepted by the patients. Its routine use in elderly patients leads to a valuable extension of diagnostic informat ion and may reduce the need of care.