Lachs M S, Feinstein A R, Cooney L M, Drickamer M A, Marottoli R A, Pannill F C, Tinetti M E
Yale University School of Medicine, New Haven, Connecticut.
Ann Intern Med. 1990 May 1;112(9):699-706. doi: 10.7326/0003-4819-112-9-699.
We propose a short, simple approach that can be used by general internists to routinely screen the functional status of elderly patients in office practice. The approach relies on checking a limited number of targets that are commonly dysfunctional but often unappreciated when conventional histories and physical examinations are done for elderly patients. The new focus is on carefully selected tests of vision, hearing, arm and leg function, urinary incontinence, mental status, instrumental and basic activities of daily living, environmental hazards, and social support systems. Brief questions and easily observed tasks are used to obtain the information needed for a suitable, effective screening while minimizing the time for administration. The approach can be incorporated into routine practice if certain relatively unproductive procedures are eliminated from the routine clinical examination, and particularly if internists are suitably compensated for the additional time.
我们提出了一种简短、简单的方法，普通内科医生可在门诊实践中常规使用该方法来筛查老年患者的功能状态。该方法依赖于检查有限数量的目标，这些目标通常存在功能障碍，但在为老年患者进行常规病史采集和体格检查时常常被忽视。新的重点是精心挑选的视力、听力、手臂和腿部功能、尿失禁、精神状态、工具性和基本日常生活活动、环境危害以及社会支持系统测试。通过简短的问题和易于观察的任务来获取进行适当、有效筛查所需的信息，同时尽量减少检查时间。如果从常规临床检查中剔除某些效率相对较低的程序，特别是如果内科医生因额外时间得到适当补偿，那么该方法可以纳入常规实践。
