Functional assessment of the elderly. A comparison of standard instruments with clinical judgment

E. M. Pinholt, K. Kroenke, J. F. Hanley, M. J. Kussman, P. L. Twyman, J. L. Carpenter

Research output: Contribution to journalArticle

Abstract

Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable though early intervention.

Original languageEnglish (US)
Pages (from-to)484-488
Number of pages5
JournalArchives of Internal Medicine
Volume147
Issue number3
DOIs
StatePublished - 1987
Externally publishedYes

Fingerprint

Nutritional Status
Gait
Nurses
Physicians
Activities of Daily Living
Visual Acuity
Inpatients

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Pinholt, E. M., Kroenke, K., Hanley, J. F., Kussman, M. J., Twyman, P. L., & Carpenter, J. L. (1987). Functional assessment of the elderly. A comparison of standard instruments with clinical judgment. Archives of Internal Medicine, 147(3), 484-488. https://doi.org/10.1001/archinte.147.3.484

Functional assessment of the elderly. A comparison of standard instruments with clinical judgment. / Pinholt, E. M.; Kroenke, K.; Hanley, J. F.; Kussman, M. J.; Twyman, P. L.; Carpenter, J. L.

In: Archives of Internal Medicine, Vol. 147, No. 3, 1987, p. 484-488.

Research output: Contribution to journalArticle

Pinholt, EM, Kroenke, K, Hanley, JF, Kussman, MJ, Twyman, PL & Carpenter, JL 1987, 'Functional assessment of the elderly. A comparison of standard instruments with clinical judgment', Archives of Internal Medicine, vol. 147, no. 3, pp. 484-488. https://doi.org/10.1001/archinte.147.3.484
Pinholt, E. M. ; Kroenke, K. ; Hanley, J. F. ; Kussman, M. J. ; Twyman, P. L. ; Carpenter, J. L. / Functional assessment of the elderly. A comparison of standard instruments with clinical judgment. In: Archives of Internal Medicine. 1987 ; Vol. 147, No. 3. pp. 484-488.
@article{c2f33738952a422895cf22cda8957e4b,
title = "Functional assessment of the elderly. A comparison of standard instruments with clinical judgment",
abstract = "Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32{\%}) of the 79 patients were mentally impaired, 31 (39{\%}) were malnourished, 18 (23{\%}) were visually impaired, 31 (39{\%}) had impaired gait, and 23 (29{\%}) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28{\%} (5/18); nutrition, 54{\%} (14/26); vision, 27{\%} (4/15); and continence, 42{\%} (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable though early intervention.",
author = "Pinholt, {E. M.} and K. Kroenke and Hanley, {J. F.} and Kussman, {M. J.} and Twyman, {P. L.} and Carpenter, {J. L.}",
year = "1987",
doi = "10.1001/archinte.147.3.484",
language = "English (US)",
volume = "147",
pages = "484--488",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - Functional assessment of the elderly. A comparison of standard instruments with clinical judgment

AU - Pinholt, E. M.

AU - Kroenke, K.

AU - Hanley, J. F.

AU - Kussman, M. J.

AU - Twyman, P. L.

AU - Carpenter, J. L.

PY - 1987

Y1 - 1987

N2 - Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable though early intervention.

AB - Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable though early intervention.

UR - http://www.scopus.com/inward/record.url?scp=0023118866&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023118866&partnerID=8YFLogxK

U2 - 10.1001/archinte.147.3.484

DO - 10.1001/archinte.147.3.484

M3 - Article

VL - 147

SP - 484

EP - 488

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 3

ER -