Palmer R M
Department of General Internal Medicine, Cleveland Clinic Foundation, Ohio, USA.
Med Clin North Am. 1999 Nov;83(6):1503-23, vii-viii. doi: 10.1016/s0025-7125(05)70177-2.
A comprehensive geriatric assessment involves the evaluation of the physical, psychosocial, and environmental factors affecting the health of an elderly person. In the office setting a geriatric assessment is best accomplished by the use of screening questions, which are incorporated into the patient's medical questionnaire; the use of validated, brief screening tests that measure the patient's performance of daily living activities, cognition, nutritional status, and risk of falls; and a review of the patient's personal values and social support network. The screening assessment can be completed in an average of ten minutes by using self-administered questionnaires and brief performance-based measures of physical functioning. The comprehensive assessment performed on the initial visit with an elderly patient will help to (1) improve diagnostic accuracy, (2) guide the selection of interventions to restore or preserve health, (3) recommend an optimal environment for care, (4) predict health outcomes, and (5) monitor clinical change over time. The effectiveness of geriatric assessment has been demonstrated in clinical trials and is likely to be most effective when conducted by the patient's primary care physician.
全面的老年医学评估涉及对影响老年人健康的身体、心理社会和环境因素进行评估。在门诊环境中，通过使用纳入患者医疗问卷的筛查问题、使用经过验证的简短筛查测试（这些测试用于衡量患者的日常生活活动能力、认知能力、营养状况和跌倒风险）以及审查患者的个人价值观和社会支持网络，能够最好地完成老年医学评估。通过使用自我管理问卷和基于表现的简短身体功能测量方法，平均十分钟即可完成筛查评估。对老年患者首次就诊时进行的全面评估将有助于：（一）提高诊断准确性；（二）指导选择恢复或保持健康的干预措施；（三）推荐最佳护理环境；（四）预测健康结果；（五）长期监测临床变化。老年医学评估的有效性已在临床试验中得到证明，并且由患者的初级保健医生进行时可能最为有效。
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