Practical functional assessment of elderly persons: a primary-care approach.

OBJECTIVE To describe simple, practical measures of physical and psychosocial function to detect problems and enhance the care of elderly patients. DESIGN We reviewed pertinent articles and current standard textbooks of geriatrics; the most useful findings are summarized, and tools that can be used for functional assessment of the geriatric population are presented. RESULTS Care of elderly patients necessitates a comprehensive review of key areas of function. Using only clinical judgment, physicians may overlook important clinical deficits common in older patients. Because of their length and complexity, many of the standard geriatric assessment tools are impractical for use by primary-care physicians. Certain simplified or condensed versions--such as the Functional Reach Test and the "Get Up and Go" Test--are efficient substitutes. In this article, we describe methods for practical identification of functional impairments, assessment of cognition and mood, evaluation of hearing and vision, and detection of problems with continence, nutrition, and social needs. Instruments for assessment of caregiver burden are also outlined. CONCLUSION Use of the assessment tools presented herein can assist primary-care physicians in comprehensive evaluation of function in older patients.