Screening for poor performance of lower extremity in primary care: the Camucia Project.
OBJECTIVE
Individuals with poor lower extremity performance are prime candidates for disability prevention. The Camucia Project is a collaborative study between geriatricians and primary care physicians (PCPs) testing the hypothesis that PCPs can use a simple performance-based test to identify older persons with poor lower extremity function, without excessive interference with their clinical routine. We also hypothesized that the number needed to screen (NNTS) a positive case would be lower in physicians' clinics than in the general population.


METHODS
23 PCPs administered the short physical performance battery (SPPB) to 360 consecutive, non-disabled and non-demented, 70- to 79-year-old outpatients. PCPs were asked to: 1) evaluate the feasibility and usefulness of administering the SPPB; 2) ascertain selected diseases according to predefined criteria; 3) identify causes of poor lower extremity function in patients with a SPPB score < or =9. NNTS from this study were compared with those estimated in non-disabled and non-demented, 70- to 79-year-old persons randomly selected from the InCHIANTI study population.


RESULTS
The majority of PCPs (20/23) reported that using the SPPB to evaluate older patients was feasible and useful. The NNTS in the outpatient clinics was lower than in the InCHIANTI participants (1.6 vs 4.3). Poor lower extremity performance was attributed to musculo-skeletal diseases in 75%, to more than one cause in 55% (128/234), and to no specific cause in 16.2% (37/234) of the participants with SPPB < or =9.


CONCLUSIONS
Screening of older persons with poor lower extremity perfomance by PCPs is feasible and efficient.
Cavazzini
Chiara
C
Laboratory of Clinical Epidemiology, Italian National Institute of Research and Care on Aging, Firenze, Italy.
Conti
Marco
M
Bandinelli
Stefania
S
Gangemi
Salvatore
S
Gallinella
Marco
M
Lauretani
Fulvio
F
Lucci
Giada
G
Windham
B Gwen
BG
Guralnik
Jack M
JM
Ferrucci
Luigi
L
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000379:methods