title: [Identification of seniors at risk--primary care: a validated questionnaire predicting functional decline].
abstract: OBJECTIVE
  To modify and validate in primary healthcare 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 65.0% at increased risk in the validation 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. This paper is a translated and adjusted version based on a publication in Journal of Clinical Epidemiology, 67 (2014) 1121-1130.
authors: Department of General Practice, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, Nederland, j.j.suijker@amc.uva.nl.
authors: Jacqueline J
authors: JJ
authors: Suijker
authors: Bianca M
authors: BM
authors: Buurman
authors: Marjon
authors: M
authors: van Rijn
authors: Marlies T
authors: MT
authors: van Dalen
authors: Gerben
authors: G
authors: ter Riet
authors: Nan
authors: N
authors: van Geloven
authors: Rob J
authors: RJ
authors: de Haan
authors: Eric P
authors: EP
authors: Moll van Charante
authors: Sophia E
authors: SE
authors: de Rooij
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011446:Prospective Studies; D011594:Psychometrics / Q000592:standards*; D012372:ROC Curve; D018570:Risk Assessment; D011795:Surveys and Questionnaires