Screening older individuals at risk...

Screening older individuals at risk of functional decline and high use of health care in a clinical setting may facilitate early intervention. The Established Populations for Epidemiological subject of attention of the Elderly (EPESE), a large research that involved physical performance measures, was able to identify the risk of death and nursing dwelling placement by administering a lower extremity performance battery. In this investigation Studenski and colleagues assessed gait spe and the EPESE measures in somewhat old patients to determine whether these assessments could predict to come health care use, health status, and functional status in a clinical setting.

Participants in the investigation were 65 years and older and received care from the Department of Veterans Affairs (VA) plan (n = 140) or a Medicare health maintenance organization (HMO; n = 347) All of the participants had a score of 24 or higher upon the Mini-Mental State Examination and a gait spe of 02 to 13 meter by second. The 487 eligible participants were given a series of health and depression assessments at baseline. Physical performance, health status, functional status, and symptoms were assessed at baseline and again at three six, nine, and 12 month Performance testing included gait spe and EPESE performance. consequence domains were health care use (i.e., single in kind or more hospitalizations, and the same or more adverse events, including hospitalization, nursing abiding-place placement, and death); health status; and functional status.

The EPESE score predicted hospitalization in HMO and VA participants, whereas gait spe predicted hospitalization solitary in the HMO group. Global health declined in 12 percent of participants; the one and the other gait speed and EPESE scores were predictive of the decline in a puddleed assessment. Functional decline in personal care occurr in 28 percent of participants, and physical function decline occurr in 27 percent of participants. Gait spe and EPESE score were herculean predictors of personal care difficulty. Physical performance measures hanged on baseline SF-36 scores (a physical function index). Patients who scored higher at baseline and who had poor performance scores had a slightly increased risk of decline.

The authors close that performance measures alone or in combination with the self-report measures included in this research are better predictors of issues than self-report alone. Incorporating simple physical performance measures in the office independently predicts use, change in health status, and decline in function. EPESE testing, which includes the chair rise and tandem stand experiments may have more predictive power than gait spe testing alone, however takes more time.

CAROLINE WELLBERY, MD

Studenski s et al. Physical performance measures in the clinical setting. J Am Geriatr Soc March 2003;51:314-22

COPYRIGHT 2003 American Academy of Family Physicians

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