[Functional assessment of elderly patients in a general practice].
To evaluate functional disabilities in elderly patients, geriatric assessment 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; number of diagnoses 5.2 +/- 2.6; f = 95, m = 49). Mini-mental-status examination showed moderately but significantly lower (p < 0.05) cognitive capacity in the age groups of 80-84 years (n = 37, 24.56 +/- 4.90 points) and of 85 years and older (n = 30, 25.14 +/- 3.11 points), but not in the group of 75-79 years (n = 46, 26.70 +/- 3.90 points) compared 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 daily living) showed significant differences between the age groups. The 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 the 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 functional assessment and number of contacts with the general practitioner in the past year, number of prescribed drugs and number of diagnoses except for the depression test. There was a significant correlation between test score, number of contacts, and number of diagnoses (p < 0.05). Functional assessment resulted in new diagnoses of urinary incontinence in 7 patients and of mobility disorders in 17 patients. Cognitive impairment was suspected in 14 patients, depression in 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Nikolaus
T
T
Geriatrisches Zentrum Bethanien am Klinikum, Universität Heidelberg.
Barlet
J
J
Burkhard
K
K
Lamar
N
N
Oster
P
P
Schlierf
G
G
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005194:Family Practice; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D005858:Germany; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data*; D009460:Neurologic Examination; D012015:Reference Standards
Funktionsuntersuchungen bei älteren Patienten in einer Hausarztpraxis.