title: Impairment in instrumental activities of daily living and the geriatric syndrome of self-neglect.
abstract: OBJECTIVE
  We sought to characterize self-neglect definitively as a geriatric syndrome by identifying an association with functional impairment.
  
  
  METHODS
  We performed a cross-sectional home evaluation of 100 community-living older adults referred by Adult Protective Services for geriatric self-neglect and 100 matched adults from a community geriatrics clinic. We made our assessments by using two manual muscle tests, a timed-gait test, a modified Physical Performance Test (mPPT), and the Kohlman Evaluation of Living Skills (KELS).
  
  
  RESULTS
  Participants in the self-neglect group had impaired mPPT (p <.077) and KELS (p <.001) scores compared with community-controls. Using analysis of covariance models, we found that self-neglect referral explained a significant proportion of the variance in KELS scores (32%; p <.001) but not in mPPT scores (22%; p =.49).
  
  
  CONCLUSIONS
  The geriatric syndrome of self-neglect is associated with increased morbidity and mortality and appears to be independently associated with impairments in instrumental activities of daily living. The evaluation and treatment of geriatric self-neglect should be consistent with that of other geriatric syndromes.
authors.affiliation: Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Aanand D
authors.initials: AD
authors.lastname: Naik
authors.forename: Jason
authors.initials: J
authors.lastname: Burnett
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pickens-Pace
authors.forename: Carmel B
authors.initials: CB
authors.lastname: Dyer
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011597:Psychomotor Performance; D018570:Risk Assessment; D012648:Self Care; D012944:Social Support; D013577:Syndrome