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GENERAL PRACTICE: Ngaire M Kerse, Leon Flicker, Damien Jolley, Bruce Arroll, and Doris Young Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme BMJ 1999; 319: 683-687 [Abstract] [Full text]

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Functional Assessment of the Elderly

Jonathan Newbury   (5 October 1999)

Functional Assessment of the Elderly 5 October 1999
Jonathan Newbury, Lecturer, Department of General Practice University of Adelaide, Australia Send response to journal: Re: Functional Assessment of the Elderly	Kerse et al1 have established the ability of appropriate education for general practitioners to improve the health of the elderly. Their educational initiative was wide ranging covering bio-medical factors such as medication use and immunisation and functional aspects, for example, exercise and social functioning. Interestingly the significant improvements in the intervention group were in walking, frequency of pleasurable activities and self rated health. This corresponds with previous British2 and Australian3 work stressing the importance of functional aspects of the health of the elderly. A randomised controlled trial of functional assessment of the elderly, aged 75 years and over, has started in Adelaide, Australia. A control group has been enrolled and left to usual care. In the intervention group a nurse is conducting functional assessments in the home and results are being reported to the person’s general practitioner. Preliminary analysis of the first of two annual visits in the intervention group has revealed a high rate of 175 functional problems in 48 people, an average of 3.65 per person. The commonest problems were; 23 with mobility problems, 20 with moderate or high nutritional risk assessed by the Australian Nutrition Screening Initiative4, 20 with fall hazards around the home, 20 with inadequate tetanus immunisation and 18 people with impaired mental state (assessed by Folstein Mini-mental state examination). Importantly only 5 of the elderly assessed were found to have no functional problems. Our work confirms the findings of Kerse of frequent problems in the elderly, many of which are detectable by nurse assessment and either preventable or manageable by appropriately skilled general practitioners. Dr. Jonathan Newbury, Lecturer. Prof. John Marley, Head of Department. Department of General Practice, University of Adelaide 5005, Australia. 1 Kerse N, Flicker L, Jolley D, Arroll B, Young D. Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme BMJ 1999; 319: 683-687. 2 Williams E I, Wallace P. Health checks for people aged 75 and over London, British Journal of General Practice, 1993, Occ. paper 59. 3 Shah, S. Harris, M F. Conforti, D. Dickson, H. Fisher, R. Elderly Care. A pilot project on opportunistic geriatric assessments in general practice. Aust Fam Phys. 1997;26: 275-8 4 Lipski P. Australian Nutrition Screening Initiative. Australian Journal on Ageing.1996; 15: (1) 14-17.