Hébert R
Gerontology and Geriatric Research Centre, Sherbrooke Geriatric University Institute, Que.
CMAJ. 1997 Oct 15;157(8):1037-45.
Functional decline is a common condition, occurring each year in nearly 12% of Canadians 75 years of age and older. The model of functional health proposed by the World Health Organization (WHO) represents a useful theoretical framework and is the basis for the SMAF (Système de measure de l'autonomie fonctionelle or Functional Autonomy Measurement System), an instrument that measures functional autonomy. The functional decline syndrome, in which functional autonomy is diminished or lost, may present as an acute condition, i.e., a medical emergency for which the patient must be admitted to a geriatric assessment unit. The subacute form is a more insidious condition in which the patient requires comprehensive assessment and a rehabilitation program. A preventive approach based on screening of those at risk and early intervention should prevent or delay the appearance of functional decline or diminish its consequences. Effective strategies for the prevention of or rehabilitation from functional decline will help reduce the incidence of disabilities and the period of dependence near the end of life. These strategies are absolute prerequisites for controlling sociohealth expenses and, most importantly, for allowing people to live independently in old age.
功能衰退是一种常见状况，每年在近12%的75岁及以上加拿大人群中出现。世界卫生组织（WHO）提出的功能健康模型是一个有用的理论框架，也是SMAF（功能自主性测量系统）的基础，SMAF是一种测量功能自主性的工具。功能衰退综合征表现为功能自主性减弱或丧失，可能呈现为急性状况，即一种需要患者入住老年评估单元的医疗急症。亚急性形式则是一种更为隐匿的状况，患者需要全面评估和康复计划。基于对高危人群进行筛查和早期干预的预防方法应能预防或延缓功能衰退的出现，或减轻其后果。预防功能衰退或使其康复的有效策略将有助于降低残疾发生率以及临终前的依赖期。这些策略是控制社会健康费用的绝对前提，最重要的是，能让人们在老年时独立生活。
