[Functional assessment of elderly patients in a general practice].

Zeitschrift fur Gerontologie Pub Date : 1994-11-01
T Nikolaus, J Barlet, K Burkhard, N Lamar, P Oster, G Schlierf
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Abstract

To evaluate functional disabilities in elderly patients, geriatric assessment was performed in one general practice. Excluded from the study were patients with severe dementia and dependence. 178 patients were asked to participate and 144 accepted (mean age 78.7 +/- 5.8 years; number of diagnoses 5.2 +/- 2.6; f = 95, m = 49). Mini-mental-status examination showed moderately but significantly lower (p < 0.05) cognitive capacity in the age groups of 80-84 years (n = 37, 24.56 +/- 4.90 points) and of 85 years and older (n = 30, 25.14 +/- 3.11 points), but not in the group of 75-79 years (n = 46, 26.70 +/- 3.90 points) compared to the group of 70-74 years (n = 31, 27.65 +/- 2.59 points). Neither the Geriatric Depression Scale nor the Barthel-Index (activities of daily living) showed significant differences between the age groups. The score of the instrumental activities of daily living (Lawton Index) was significantly lower (p < 0.05) in the age group 85 years and older (4.1 +/- 2.5 points) compared to the age group of 70-74 years (6.1 +/- 2.4 points). Grip strength was significantly reduced (p < 0.01) in the age group 85 years and older as well as motility and balance scores (Tinetti test; p < 0.05) compared to the group of 70-74 years (43.21 +/- 16.27 kp and 64.87 +/- 19.81 kp, resp., 19.3 +/- 6.6 and 23.1 +/- 5.9 points). No correlation was found between the results of functional assessment and number of contacts with the general practitioner in the past year, number of prescribed drugs and number of diagnoses except for the depression test. There was a significant correlation between test score, number of contacts, and number of diagnoses (p < 0.05). Functional assessment resulted in new diagnoses of urinary incontinence in 7 patients and of mobility disorders in 17 patients. Cognitive impairment was suspected in 14 patients, depression in 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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【全科医学中老年患者的功能评估】。
为了评估老年患者的功能障碍,在一个全科医生中进行了老年评估。该研究排除了严重痴呆和依赖性患者。178名患者被要求参与,144名患者被接受(平均年龄78.7±5.8岁;诊断数5.2 +/- 2.6;F = 95, m = 49)。迷你精神状态检查显示80 ~ 84岁年龄组(n = 37, 24.56 +/- 4.90分)和85岁及以上年龄组(n = 30, 25.14 +/- 3.11分)认知能力较70 ~ 74岁组(n = 31, 27.65 +/- 2.59分)有中度但显著性降低(p < 0.05), 75 ~ 79岁组(n = 46, 26.70 +/- 3.90分)无显著性差异。老年抑郁量表和barthel指数(日常生活活动)在年龄组之间均无显著差异。85岁及以上年龄组的日常生活工具活动(劳顿指数)得分(4.1 +/- 2.5分)显著低于70-74岁年龄组(6.1 +/- 2.4分),差异有统计学意义(p < 0.05)。85岁及以上年龄组握力显著降低(p < 0.01),运动和平衡得分显著降低(Tinetti测试;P < 0.05),高于70 ~ 74岁组(43.21 +/- 16.27 KP和64.87 +/- 19.81 KP, P < 0.05)。(19.3 +/- 6.6和23.1 +/- 5.9)。功能评估结果与过去一年中与全科医生接触的次数、处方药物的数量和除抑郁测试外的诊断次数之间没有相关性。测试分数、接触次数和诊断次数之间存在显著相关(p < 0.05)。功能评估导致7例患者新诊断为尿失禁,17例患者新诊断为活动障碍。认知功能障碍14例,抑郁2例。(摘要删节250字)
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