Upload
gilbert-robertson
View
213
Download
0
Tags:
Embed Size (px)
Citation preview
Functional capacity
Total Score: 0-12It should be calculated by adding theScore in each one of the three partsof the test (Balance, Gait and Chair Stand)
Decreases in 1 point regarding previousScores in the same patient are of clinicalrelevance
Mortality rates according to single score(adjusted by age and sex)
11,7
7,8
9,0
6,6
4,5
6,1
4,3
3,2
4,4
3,03,6
3,0
1,92,5
3,0
0
5
10
15
Dea
ths
per
100
Per
son
-Yea
rs
Walk Chair Stands Standing Balance% Distribution 5 23 25 26 22 22 19 20 20 19 10 15 13 14 49
0 1 2 3 4Test Category 0 1 2 3 4 0 1 2 3 4
Guralnik JM, et al. J Gerontol Med Sci. 1994;49:M85-M94.
Age and Sex Adjusted
De
ath
s p
er 1
00
Pe
rso
n–
Ye
ars
Performance Test Summary Score
Guralnik JM, et al. J Gerontol Med Sci. 1994;49:M85-M94.
Mortality rates as a function of the overall score
Age and Sex Adjusted Guralnik JM, et al. J Gerontol Med Sci. 1994;49:M85-M94.
Insitutionalization rates as a function of the overall punctuation
Functional status at 4 years as a function of baseline gait velocity in non-disabled older people
0%
Guralnik JM, et al.N Engl J Med. 1995; 332: 556-61.
0.42 0.43 – 0.59 0.60 – 0.77 0.78
Gait velocity (m/sec)
Category 1 2 3 4
20%
40%
60%
80%
100%
Stat
us o
f dis
abili
ty(%
of s
ubje
cts)
Iowa EPESE
No disability
Mobility affected
Impairment in BADL+ Mobility
Risk of falls/Risk of fracturesNICE document to assess risk of falls
FRAX INDEX to assess risk of fractures
COGNITIVE AND AFECTIVE ASSESSMENT
Take home messages
DM impacts several functional domains. Function is the best predictor of adverse events in these patients.A comprehensive assessment of older people with DM must include not only classical clinical components but also function, cognition, mood, risk of falls and fractures, nutrition and social support.There are many validated instruments to assess all of those domains.They are easy to use, inexpensive and friendly for both the patient and the evaluator.