[The risk assessment of the need for help and care as well as the risk of mortality among older people. The results of an 18-month pilot study in a family practice].
OBJECTIVE
To investigate prospectively the prognostic power of various demographic and diagnostic parameters, as well as of medical history, for evaluating in elderly patients the probability of their requiring care and of their risk of dying soon.


METHODS
All the elderly patients (> or = 70 years) of one general practitioner were included. Of 178 patients who fulfilled the inclusion criteria, 144 participated (93 women, 49 men; mean age 78.7 +/- 5.8 years). Demographic, basic diagnostic and medical history data of the kind that can be easily collected in general practice were recorded. The general practitioner was also asked to assess the probability of each patient requiring care and the likelihood of their dying soon. Several functional tests that record or measure daily activity were conducted. After 18 months all admissions to care, homes for the elderly or hospital and deaths were recorded. The different groups were compared.


RESULTS
The probability of requiring care and of dying within the observation period were predicted more accurately by functional tests and questions than by conventional diagnostic methods. This was particularly so for functional investigations of basic daily activity, cognitive ability and manual skills. There were significant differences between the groups in the results of tests (P < 0.01).


CONCLUSIONS
Functional tests can be rapidly performed and have high diagnostic and prognostic power. They are therefore recommended for use by general practitioners for assessing the probability of a given patient requiring care and for estimating the likelihood of early death.
Nikolaus
T
T
Geriatrisches Zentrum Bethanien am Klinikum, Universität sowie Fakultät Medizin I (Allgemeinmedizin), Universität, Heidelberg.
Barlet
J
J
Sauer
B
B
Oster
P
P
Schlierf
G
G
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009026:Mortality; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment
Beurteilung des Risikos von Hilfs- und Pflegebedürftigkeit sowie des Mortalitätsrisikos älterer Menschen. Ergebnisse einer 18monatigen Pilotstudie in einer Hausarztpraxis.