PRACTICAL FUNCTIONAL ASSESSMENT OF ELDERLY PERSONS - A PRIMARY-CARE APPROACH

Objective: To describe simple, practical measures of physical and psyc hosocial function to detect problems and enhance the care of elderly p atients. Design: We reviewed pertinent articles and current standard t extbooks of geriatrics; the most useful findings are summarized, and t ools that can be used for functional assessment of the geriatric popul ation are presented. Results: Care of elderly patients necessitates a comprehensive review of key areas of function. Using only clinical jud gment, physicians may overlook important clinical deficits common in o lder patients. Because of their length and complexity, many of the sta ndard geriatric assessment tools are impractical for use by primary-ca re physicians. Certain simplified or condensed versions-such as the Fu nctional Reach Test and the ''Get Up and Go'' Test-are efficient subst itutes. In this article, we describe methods for practical identificat ion of functional impairments, assessment of cognition and mood, evalu ation of hearing and vision, and detection of problems with continence , nutrition, and social needs. Instruments for assessment of caregiver burden are also outlined. Conclusion: Use of the assessment tools pre sented herein can assist primary-care physicians in comprehensive eval uation of function in older patients.