scholarly journals Predictive Validity of a Postal Questionnaire for Screening Community-dwelling Elderly Individuals at Risk of Functional Decline

1996 ◽  
Vol 25 (2) ◽  
pp. 159-167 ◽  
Author(s):  
RáJEAN HáBERT ◽  
GINA BRAVO ◽  
NICOL KORNER-BITENSKY ◽  
LOUIS VOYER
Keyword(s):  
At Risk ◽  
Predictive Validity ◽  
Functional Decline ◽  
Postal Questionnaire ◽  
Community Dwelling ◽  
Elderly Individuals

Predictive Validity of a Postal Questionnaire for Screening Elderly at Risk of Functional Decline in the Community

1994 ◽  
Vol 23 (suppl 1) ◽  
pp. P18-P18
Author(s):  
R. HEbert ◽  
G. Bravo ◽  
N. Korner-Bitensky ◽  
L. Voyer
Keyword(s):  
At Risk ◽  
Predictive Validity ◽  
Functional Decline ◽  
Postal Questionnaire

scholarly journals 262 Training and Use of the 4AT by a Multi-disciplinary Team to Screen for Delirium in the Frail Adult

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siobhan Ryan ◽  
Eamonn Cooney ◽  
Karen Sayers ◽  
Aine O'Reilly ◽  
Jennifer Maher ◽  
...  
Keyword(s):  
At Risk ◽  
Visual Impairment ◽  
Functional Decline ◽  
Interdisciplinary Team ◽  
Interdisciplinary Teams ◽  
Community Dwelling ◽  
Patients At Risk ◽  
The Mean ◽  
The Relationship ◽  
Multi Disciplinary Team

Abstract Background Detection of delirium risk may improve outcomes. We assessed the prevalence of patients at risk of delirium assessed by a trained interdisciplinary team. Methods An interdisciplinary team: dietitian, physiotherapist and speech and language therapist was trained to use the 4AT. Community dwelling patients, identified as frail during triage in a hospital emergency department, were assessed including a 4AT, over a 2 month period. Age, gender, Clinical Frailty Score (CFS), 4AT, Modified Barthel index (mBI), polypharmacy (as defined by 5 or more medications) and presence of hearing or visual impairment were entered onto Excel. Performance of the 4AT was at the discretion of the assessor. Results 150 consecutive patients were assessed. The mean(SD) age was 83(5.1). Female to male ratio was 1.2:1. Mean(SD) CFS was 5.6(1.0). 29(19%) patients did not have a 4AT performed. 63(42%) patients had a 4AT of 1-3. 16(11%) patients had a 4AT of 4 or greater. 42(28%) had a 4AT of zero. Patients with a 4AT 4 or greater were older, mean(SD) age 86(4.2)years. Polypharmacy was present in 10(60%) patients with 4AT 4 or greater and 40(38%) with 4AT less than 4. 10(60%) of patients with 4AT 4 or greater had hearing and visual impairment. 16(15%) patients with a 4AT less than 4 had hearing and visual impairment. 10(60%) of patients with 4AT 4 or greater had a reduction in mBI. 33(31%) of patients with a 4AT less than 4 had a reduction in mBI. Conclusion Interdisciplinary teams can screen for delirium risk in ED. Frail patients at risk of delirium are older, have higher rates of polypharmacy, visual and hearing impairment and functional decline. It is possible to evaluate delirium in ED. Further work is needed to explore the relationship between the 4AT and frailty.

scholarly journals MP016: Measuring frailty can help emergency departments identify seniors at risk of functional decline after minor injuries

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S71-S72
Author(s):  
N. Allain-Boulé ◽  
M. Sirois ◽  
L.E. Griffith ◽  
M. Émond ◽  
B. Batomen Kuimi
Keyword(s):  
At Risk ◽  
Emergency Departments ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Functional Decline ◽  
Community Dwelling ◽  
Post Injury ◽  
Clinical Frailty Scale ◽  
Minor Injuries ◽  
A Minor

Introduction: The CETI team has shown that around 18% of otherwise independent seniors remain in a state functional decline up to six months after a minor injury. In that context, frailty may be associated with increased likelihood of decline. As most seniors consult Emergency Departments (EDs) when injured, measuring frailty may help identify those at risk of functional decline. Objectives: This study aims to 1) describe frailty in the sub-group of independent community-dwelling seniors consulting Emergency Departments (ED) for minor injuries, 2) examine the association between frailty and functional decline three months post-injury, 3) ascertain the predictive accuracy of frailty measures and Emergency Physicians’ (EPs) for functional decline. Methods: Prospective cohort in 2011-2013 among 1072 seniors aged ≥ 65, independent in basic daily activities, evaluated in Canadian EDs for minor injuries and discharged home. Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS) and the Study of Osteoporotic Fracture index (SOF). Functional decline was defined as a loss ≥ 2/28 on the Older American Resources Services scale three months post-injury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas Under the Receiver operating characteristic curve (AUC) were used to ascertain the predictive accuracy of frailty measures and EPs’ clinical judgement. Results: The SOF and CSHA-CFS were available in 342 and 1058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail and frail. These CSHA-CFS (n=1058) proportions were 51.9%, 38.3% and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%-14.6%). The AUCs of the CSHA-CFS and the EPs’ were similar (0.548 - 0.777), while the SOF was somewhat higher (0.704 - 0.859). Conclusion: Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed.

scholarly journals Predictive Validity of a New Instrumental Activities of Daily Living Scale for Detecting the Incidence of Functional Disability among Community-Dwelling Older Japanese Adults: A Prospective Cohort Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2291
Author(s):  
Keitaro Makino ◽  
Sangyoon Lee ◽  
Seongryu Bae ◽  
Yohei Shinkai ◽  
Ippei Chiba ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Predictive Validity ◽  
Daily Living ◽  
Functional Disability ◽  
Functional Decline ◽  
Community Dwelling ◽  
Self Report ◽  
Term Care ◽  
Instrumental Activities ◽  
Japanese Adults

We examined the predictive validity of a newly developed scale—the National Center for Geriatrics and Gerontology Activities of Daily Living (NCGG-ADL)—to measure instrumental activities of daily living (IADL) ability. We tested the scale for detecting new incidences of functional disability among community-dwelling older Japanese adults. Participants were 2708 older adults (mean age = 79.0 years, 51.6% women) living in the community who had no functional decline at baseline. We assessed IADL ability using the NCGG-ADL scale, comprising 13 self-report questions. Next, we assessed their functional disability monthly for 24 months, based on the national long-term care insurance (LTCI) system. Among all participants, 430 (15.9%) had an IADL limitation at baseline, and 289 (10.7%) were newly certified as functionally disabled. Participants scoring ≤ 12 of 13 points in the NCGG-ADL showed a significantly higher risk of functional disability than did those scoring 13 points, even after adjusting for covariates (hazard ratio [95% confidence interval] = 1.58 [1.19–2.09]). We thus validated the NCGG-ADL as a screening tool for assessing the risk of functional disability among community-dwelling older Japanese adults. We conclude that IADL limitations, as measured by the NCGG-ADL, could be useful predictors of functional disability.

A preventive program for community-dwelling elderly at risk of functional decline: a pilot study

2000 ◽  
Vol 30 (1) ◽  
pp. 73-84 ◽  
Author(s):  
Line Robichaud ◽  
Réjean Hébert ◽  
Pierre-M. Roy ◽  
Chantale Roy
Keyword(s):  
At Risk ◽  
Pilot Study ◽  
Functional Decline ◽  
Community Dwelling ◽  
Preventive Program

scholarly journals Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Gerontology ◽  
2017 ◽  
Vol 64 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Nini H. Jonkman ◽  
Vieri Del Panta ◽  
Trynke Hoekstra ◽  
Marco Colpo ◽  
Natasja M. van Schoor ◽  
...  
Keyword(s):  
At Risk ◽  
Functional Ability ◽  
Gait Speed ◽  
Latent Class ◽  
Prediction Models ◽  
Functional Decline ◽  
Community Dwelling ◽  
Receiver Operating Curve ◽  
Males And Females

Background: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions. Objective: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years. Methods: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex. Results: Three distinct trajectories were identified: no/little decline (219 males, 241 females), intermediate decline (114 males, 158 females), and severe decline (36 males, 30 females). Higher gait speed showed decreased risk of functional limitations in males (intermediate limitations, odds ratio [OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI 0.26-0.66). The final model in males further included the predictors fear of falling and alcohol intake (no/little decline, area under the receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI 0.71-0.87). In females, higher gait speed showed a decreased risk of intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females were age, living alone, economic satisfaction, balance, physical activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80, 95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79; severe decline, AUC 0.95, 95% CI 0.91-0.99). Conclusion: Already in people aged 60-70 years, 3 distinct trajectories of functional decline were identified in these cohorts over a 9-year follow-up. Predictors of trajectories differed between males and females, except for gait speed. Identification of people at risk is the basis for targeting interventions.

Functional decline in frail community-dwelling stroke patients

2006 ◽  
Vol 13 (1) ◽  
pp. 17-23 ◽  
Author(s):  
F. Landi ◽  
G. Onder ◽  
M. Cesari ◽  
V. Zamboni ◽  
A. Russo ◽  
...  
Keyword(s):  
Functional Decline ◽  
Community Dwelling ◽  
Stroke Patients
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