Frederiks C M
Tijdschr Gerontol Geriatr. 1986 Oct;17(5):205-8.
Preventive medical examination in aged people has some disadvantages when executed as a form of screening of the general population. There are almost no diseases to be found in aged persons, which meet the criteria for screening. It is likely that more needless disturbance is caused than actual case-finding achieved. Non-response in aged people will be high. And at last multiple pathology in aged people brings about that the total health-state is more important than the occurrence of specific diseases. These disadvantages can be partly solved by way of pre-selection of high risk aged persons. This increases the predictive value of the diagnostic tests; partly precluding non-response by means of having the first preventive examination at home; and determining the state of health in first instance by asking questions about ADL, house-keeping abilities, state of mental health, nutrition, a.o. The possibility of the community nurse paying home visits in stead of preventive medical examination will be discussed.
作为一般人群筛查形式的老年人预防性医学检查存在一些弊端。在老年人中几乎找不到符合筛查标准的疾病。很可能造成的不必要干扰比实际发现的病例更多。老年人的不响应率会很高。最后，老年人的多种病理状况导致总体健康状况比特定疾病的发生更为重要。这些弊端可以通过对高危老年人进行预先筛选的方式部分解决。这提高了诊断测试的预测价值；部分地通过在家中进行首次预防性检查来排除不响应情况；并首先通过询问日常生活活动、家务能力、心理健康状况、营养状况等问题来确定健康状况。将讨论社区护士进行家访代替预防性医学检查的可能性。
