SYMPTOMS AS PREDICTORS OF FUNCTIONING IN THE COMMUNITY-DWELLING ELDERLY

This survey was carried out to explore the relationship between sympto ms and functional status in the elderly living at home. The setting is an urban area of Turin (Northern Italy). A cross-sectional screening for 20 symptoms was completed in 747 subjects, aged 75 and older. Depe ndence in basic Activities of Daily Living (ADL) and in Instrumental A ctivities of Daily Living (IADL), Short Portable Mental Status Questio nnaire and Cumulative Illness Rating Scale were also ascertained. A di scriminant analysis was performed to determine the potential value of symptoms in predicting functional impairment. The mean number of sympt oms was 6.0 per subject (+/- S.D. 3.3) and dependence in ADLs was 8.2% . Amongst a 20-symptom list, six symptoms (fatigue, memory loss, indig estion, nutrition, hearing and speaking problems), either alone or in association, showed sufficient discriminatory power to identify depend ence in ADLs (sensitivity = 72%), mental impairment (72%), psychologic al distress (80%), but not dependence in IADLs (48%). Symptoms are com mon in the free-living elders, but their functional status is good. A short (6 items) formal screening for symptoms may be a simple way to p redict functioning and to rapidly manage problems. (C) 1998 Elsevier S cience Ireland Ltd. All rights reserved.