Title |
Prediction of functional decline in community-dwelling older persons in general practice: a cohort study
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Published in |
BMC Geriatrics, June 2018
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DOI | 10.1186/s12877-018-0826-z |
Pubmed ID | |
Authors |
Sophie C. E. van Blijswijk, Jeanet W. Blom, Anton J. M. de Craen, Wendy P. J. den Elzen, Jacobijn Gussekloo |
Abstract |
A first step to offer community-dwelling older persons proactive care is to identify those at risk of functional decline within a year. This study investigates the predictive value of registered information, questionnaire and GP-opinion on functional decline. In this cohort study, embedded within the ISCOPE-trial, participants (≥75 years) completed the ISCOPE-screening questionnaire on four health domains. GPs gave their opinion on vulnerability of participants. Functional status was measured at baseline and 12 months (Groningen Activities Restriction Scale [GARS]). The outcome was functional decline (death, nursing home admission, 10% with greatest functional decline). The predictive value of pre-selected variables (age, sex, polypharmacy, multimorbidity, living situation; GPs' opinion on vulnerability, number of domains with problems [ISCOPE-score]) was compared with the area under the curves (AUC) for logistic regression models. 2018 of the 2211 participants (median age 82.1 years [IQR 78.8-86.5], 68.0% female, median GARS 31 [IQR 24-41]) were visited at 12 months (median GARS 34 [IQR 26-44]). 394 participants (17.8%) had functional decline (148 died, 45 nursing home admissions, 201 with greatest functional decline). The AUC for age and sex was 0.602, increasing to 0.620 (p = 0.029) with polypharmacy, multimorbidity and living situation. The GPs' opinion added more (AUC 0.672, p < 0.001) than the ISCOPE-score (AUC 0.649, p = 0.007). AUC with all variables was 0.686 (p = 0.016), and 0.643 for GPs' opinion alone. The GPs' opinion and ISCOPE-score improve this prediction model for functional decline based on readily available variables. GPs could identify older patients for further assessment with their clinical judgement. Netherlands trial register, NTR1946 . Registered 10 August 2009. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 64 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 10 | 16% |
Student > Bachelor | 6 | 9% |
Researcher | 6 | 9% |
Student > Ph. D. Student | 6 | 9% |
Student > Doctoral Student | 5 | 8% |
Other | 8 | 13% |
Unknown | 23 | 36% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 18 | 28% |
Medicine and Dentistry | 13 | 20% |
Psychology | 3 | 5% |
Engineering | 2 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Other | 4 | 6% |
Unknown | 22 | 34% |