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A Simple Procedure for General Screening for Functional Disability in Elderly Patients

Mark S. Lachs, MD; Alvan R. Feinstein, MD; Leo M. Cooney Jr., MD; Margaret A. Drickamer, MD; Richard A. Marottoli, MD; Fitzhugh C. Pannill, MD; and Mary E. Tinetti, MD
[+] Article and Author Information

Requests for Reprints: Alvan R. Feinstein, MD, Yale University School of Medicine, Department of Medicine, 333 Cedar Street, IE-456 SHM, New Haven, CT 06510.

Current Author Addresses: Dr. Lachs: Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, IE-61 SHM, New Haven, CT 06510.

Drs. Cooney, Marottoli, and Tinetti: Yale University School of Medicine, Department of Medicine, 333 Cedar Street, PO Box 3333, New Haven, CT 06510.

Drs. Drickamer and Pannill: Section of Geriatrics, Department of Medicine (111C), West Haven VA Medical Center, West Haven, CT 06516.

Dr. Feinstein: Yale University School of Medicine, Department of Medicine, 333 Cedar Street, IE-456 SHM, New Haven, CT 06510.


© 1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;112(9):699-706. doi:10.7326/0003-4819-112-9-699
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We propose a short, simple approach that can be used by general internists to routinely screen the functional status of elderly patients in office practice. The approach relies on checking a limited number of targets that are commonly dysfunctional but often unappreciated when conventional histories and physical examinations are done for elderly patients. The new focus is on carefully selected tests of vision, hearing, arm and leg function, urinary incontinence, mental status, instrumental and basic activities of daily living, environmental hazards, and social support systems. Brief questions and easily observed tasks are used to obtain the information needed for a suitable, effective screening while minimizing the time for administration. The approach can be incorporated into routine practice if certain relatively unproductive procedures are eliminated from the routine clinical examination, and particularly if internists are suitably compensated for the additional time.

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