Hall R G, Channing D M
Norton Medical Centre, Stockton on Tees, Cleveland.
BMJ. 1990 Sep 1;301(6749):424-8. doi: 10.1136/bmj.301.6749.424.
To examine how functional disability varies with sex, age, and other variables in patients aged 75 and over living in the community and to ascertain whether a statistical model derived from the variables in this population usefully predicted functional disability in another of similar age.
Retrospective study of data collected by interview and by examination of medical records.
An urban general practice with five partners and a list of 15,000 patients, very few of whom belonged to ethnic minorities.
775 Patients (252 men, 523 women) aged 75 and over living in the community between September 1985 and August 1986; 13 other patients considered to be unsuitable and 14 who declined an interview were excluded. Also 94 patients who became 75 or joined the practice after August 1986.
The proportions of fit, partially disabled, and severely disabled (housebound) patients.
90 Men (35.7%) and 128 women (24.5%) were fit, and 27 men (10.7%) and 116 women (22.2%) were housebound; in all age groups women were significantly more likely to be disabled than men. A significant trend towards greater disability was shown with increasing age and, more noticeably, with pattern of consultation when patients were divided into three categories based on the number of times they had attended the surgery and been visited at home over about two years. Statistical models gave the forecast percentage of fit and severely disabled patients for each sex, age group, and pattern of consultation, and a simple scheme was derived to identify from information wholly contained in medical records most of those patients most prone to severe disability. The scheme was verified applying it to a population of 94 elderly patients in 1988-9.
Sex, age, and pattern of consultation together provide a quick indication of elderly patients' tendency to severe disability, which can help in screening and in day to day consultations.
研究社区中75岁及以上患者的功能残疾如何随性别、年龄和其他变量而变化，并确定从该人群变量得出的统计模型是否能有效预测另一相似年龄人群的功能残疾情况。
通过访谈和查阅病历收集数据的回顾性研究。
一家有五名合伙人、拥有15000名患者名单的城市全科诊所，其中极少数为少数民族患者。
1985年9月至1986年8月期间居住在社区的775名75岁及以上患者（252名男性，523名女性）；另外13名被认为不适合的患者以及14名拒绝访谈的患者被排除。还有94名在1986年8月后年满75岁或加入该诊所的患者。
健康、部分残疾和严重残疾（足不出户）患者的比例。
90名男性（35.7%）和128名女性（24.5%）健康，27名男性（10.7%）和116名女性（22.2%）足不出户；在所有年龄组中，女性比男性更易残疾。随着年龄增长，尤其是根据患者在大约两年内就诊次数和家访次数分为三类的就诊模式，残疾程度有显著增加趋势。统计模型给出了每种性别、年龄组和就诊模式下健康和严重残疾患者的预测百分比，并得出了一个简单方案，可根据病历中完全包含的信息识别出最易出现严重残疾的大多数患者。该方案在1988 - 1989年应用于94名老年患者群体进行了验证。
性别、年龄和就诊模式共同为老年患者严重残疾倾向提供了快速指示，有助于筛查和日常诊疗。
