Building evidence on chronic disease in old age

Standardised assessments and databases offer one way of building the evidence

Evidence based medicine, clinical effectiveness, and performance indicators are the topics of the moment, but their applicability to frail elderly people in community and institutional settings is problematic because of insufficient relevant evidence. About 2-15% of the population aged over 65 of industrialised countries are residents in nursing homes and related facilities. These elderly people have multiple impairments and chronic diseases, features that generally exclude them from randomised controlled trials. There are, however, other methods that can be used to gather the evidence on which we can base our interventions for these older people.

Standardised assessment measures go beyond diagnosis to include physical and psychosocial function and must be included in an evaluation of health care for older people. The creation of databases containing such data in conjunction with data on treatments could begin to fill the gaps of missing evidence. 1 2 Under certain conditions and for certain applications, research based on clinical databases has been favourably compared with …