title: A simple validated questionnaire predicted functional decline in community-dwelling older persons: prospective cohort studies.
abstract: OBJECTIVE
  To modify and validate in primary health care the Identification of Seniors At Risk (ISAR) screening questionnaire to identify older persons at increased risk of functional decline and to compare this strategy with risk stratification by age alone.
  
  
  METHODS
  Prospective development (n = 790) and validation cohorts (n = 2,573) of community-dwelling persons aged ≥70 years. Functional decline at 12 months was defined as an increase of at least one point on the modified Katz-activities of daily living index score compared with baseline or death.
  
  
  RESULTS
  Three items were independently associated with functional decline: age (odds ratio [OR]: 1.06 per year; 95% confidence interval [CI]: 1.02, 1.10), dependence in instrumental activities of daily living (OR: 2.17; 95% CI: 1.46, 3.22), and impaired memory (OR: 2.22; 95% CI: 1.41, 3.51). The area under the receiver operating characteristics curve (AUC) range of the ISAR-primary care model was 0.67-0.70, and 40.6% was identified at increased risk. Validation yielded an AUC range of 0.63-0.64. Age ≥75 years alone yielded an AUC range of 0.56-0.57 and identified 55.4% at increased risk in the development cohort.
  
  
  CONCLUSIONS
  Although the ISAR-Primary Care (ISAR-PC) has moderate predictive value, application of the ISAR-PC is more efficient than selection based on age alone in identifying persons at increased risk of functional decline.
authors.affiliation: Department of General Practice, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands. Electronic address: j.j.suijker@amc.uva.nl.
authors.forename: Jacqueline J
authors.initials: JJ
authors.lastname: Suijker
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Buurman
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Marjon
authors.initials: M
authors.lastname: van Rijn
authors.affiliation: Department of General Practice, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Marlies T
authors.initials: MT
authors.lastname: van Dalen
authors.affiliation: Department of General Practice, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Gerben
authors.initials: G
authors.lastname: ter Riet
authors.affiliation: Clinical Research Unit, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Nan
authors.initials: N
authors.lastname: van Geloven
authors.affiliation: Clinical Research Unit, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: de Haan
authors.affiliation: Department of General Practice, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Moll van Charante
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center - University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: de Rooij
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D057187:Independent Living; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Elderly; Functional decline; General practice; Longitudinal study; Screening tool; Self-reported outcome