title: Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline.
abstract: Screening elderly individuals who are at risk of functional decline in the community is essential in order to implement effective programmes of assessment and surveillance in a context of secondary prevention. The postal questionnaire technique consists of sending a simple questionnaire to all elderly individuals living in a defined area in order to identify those who are at risk. The objective of this study was to develop a postal questionnaire and to test its capacity to predict functional decline in community-dwelling elderly people. A 21-item postal questionnaire was sent with a birthday card to a representative sample of community-dwelling individuals over the age of 75 years (n = 842). One month after sending the questionnaire, all subjects were contacted by a nurse for an in-home interview (n = 655) that included assessment of functional autonomy. One year later, the subjects (n = 607) were reassessed by the same nurse. Of the eligible subjects, 87.4% returned the postal questionnaire. During the year following the completion of the postal questionnaire, 43 subjects died, 13 were institutionalized and 109 had experienced a significant decrease on the autonomy scale, for a total annual occurrence of functional decline of 27.2%. Age and 14 of the 21 items of the questionnaire were associated with a significant relative risk of functional decline. The relative risk associated with not responding to the questionnaire was 2.1. A stepwise logistic regression analysis showed that six items were independent predictors of functional decline. This 6-item Sherbrooke Postal Questionnaire identifies as positive 56% of the population with 75% sensitivity and 52% specificity. We conclude that a postal questionnaire is a feasible and valid technique for screening elderly individuals at risk for functional decline.
authors.affiliation: Centre de recherche en gérontologie et geriatrie, Hôpital d'Youville, Sherbrooke, Québec, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Hébert
authors.forename: G
authors.initials: G
authors.lastname: Bravo
authors.forename: N
authors.initials: N
authors.lastname: Korner-Bitensky
authors.forename: L
authors.initials: L
authors.lastname: Voyer
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D011792:Quebec; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires