Screening the elderly. A brief instrumental activities of daily living measure.

Although multidimensional functional assessment may be the route of choice in determining the personal status of the elderly and the services they need, the majority of the elderly are well and competent, making it hard to justify routine extensive assessment with its attendant costs. Described herein is a brief, valid, and reliable five-item screener based on instrumental activities of daily living which can rapidly identify elderly community residents with impaired functional capacity, and which, because of its substantial correlation with physical health (r = .54 to .55), mental health (r = .54 to .60), and predictability of death can identify those for whom more extensive assessment is warranted. Use of such a brief screener should result in better targeting of elderly in need of service, facilitate coordinated and efficient health care delivery, and maintain the functional independence of the elderly.