Beurteilung des Risikos von Hilfs- und Pflegebedürftigkeit sowie des Mortalitätsrisikos älterer Menschen: Ergebnisse einer 18monatigen Pilotstudie in einer Hausarztpraxis

OBJECTIVE: To investigate prospectively the prognostic power of various demographic and diagnostic parameters, as well as of medical history, for evaluating in elderly patients the probability of their requiring care and of their risk of dying soon. PATIENTS AND METHOD: All the elderly patients (> or = 70 years) of one general practitioner were included. Of 178 patients who fulfilled the inclusion criteria, 144 participated (93 women, 49 men; mean age 78.7 +/- 5.8 years). Demographic, basic diagnostic and medical history data of the kind that can be easily collected in general practice were recorded. The general practitioner was also asked to assess the probability of each patient requiring care and the likelihood of their dying soon. Several functional tests that record or measure daily activity were conducted. After 18 months all admissions to care, homes for the elderly or hospital and deaths were recorded. The different groups were compared. RESULTS: The probability of requiring care and of dying within the observation period were predicted more accurately by functional tests and questions than by conventional diagnostic methods. This was particularly so for functional investigations of basic daily activity, cognitive ability and manual skills. There were significant differences between the groups in the results of tests (P < 0.01). CONCLUSION: Functional tests can be rapidly performed and have high diagnostic and prognostic power. They are therefore recommended for use by general practitioners for assessing the probability of a given patient requiring care and for estimating the likelihood of early death.