title: Screening for poor performance of lower extremity in primary care: the Camucia Project.
abstract: 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.
authors.affiliation: Laboratory of Clinical Epidemiology, Italian National Institute of Research and Care on Aging, Firenze, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cavazzini
authors.forename: Marco
authors.initials: M
authors.lastname: Conti
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gangemi
authors.forename: Marco
authors.initials: M
authors.lastname: Gallinella
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.forename: Giada
authors.initials: G
authors.lastname: Lucci
authors.forename: B Gwen
authors.initials: BG
authors.lastname: Windham
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: 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