Evaluación geriátrica en la atención primaria / Geriatric assessment in the primary care

ABSTRACT

BACKGROUND: A good medical care program for the elderly requires a thorough assessment of the functional capacity and limitations of the consulting patients. AIM: To perform a geriatric assessment to elderly subjects consulting in a public outpatient clinic. PATIENTS AND METHODS: A cross sectional assessment of subjects over 60 years old, beneficiaries of the public health care system and consulting in 4 outpatient clinics of a poor community of Metropolitan Santiago. Evaluation included a complete medical history, the Katz score for activities of daily living (ADL), Lawton score for instrumental activities for daily living (IADL) and Folstein Mini Mental state examination. RESULTS: During the study period 1,023 subjects, 73 per cent female, aged 74 +/- 7 years, were assessed. Thirteen percent were illiterate, 78 per cent elementary school, 8 per cent had high school and 0.2 per cent university education. Eighty eight percent lived with relatives, 79 per cent did not participate in community groups and 7 per cent smoked. The most common chronic disease detected was high blood pressure in 61 per cent, followed by obesity in 32 per cent, osteoarthritis in 22 per cent, diabetes mellitus in 17 per cent, depression in 11 per cent, cardiac diseases in 8 per cent, hypothyroidism in 3 per cent and epilepsy in 1 per cent. ADL score showed partial dependency in 11 per cent and total dependency in 2 per cent. IADL score showed partial dependency in 41 per cent and total dependency in 4 per cent. Mini Mental score was abnormal in 31 per cent of subjects. CONCLUSIONS: High blood pressure, osteoarthritis, depression and cognitive impairment are the most common health problems in this sample of elderly subjects. ADL score showed a low rate of dependency.