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[Application of a geriatric evaluation protocol in primary care: comparison with data from the clinical history]
I López Pavón1, M Roset Bartrolí, B Iglesias Pérez
1Centro de Atención Primaria Centre-Can Mariner, Dirección de Atención Primaria Santa Coloma de Gramenet, Barcelona.
Objectives:
To determine the prevalence of the health problems included in a multidimensional geriatric assessment (MGA) protocol and to compare them with the problems detected in the clinical histories (CH) of the population consulting at a primary care centre (PCC).
Design:
Cross-sectional observational.
Setting:
Urban PCC (metropolitan area of Barcelona).
Patients:
Users > or = 65 of a PCC between 01/11/97 and 31/01/98.
Measurements And Main Results:
A random sample of 114 people was chosen. The MGA protocol was used to screen disorders in: hearing, vision, mobility, affective state, cognitive state, social support, functionalism of the instrumental activities of daily life. The clinical histories provided age, sex and information previously recorded on these disorders. 102 people were surveyed (participation: 89.5%). The MGA enabled more problems to be detected, with the difference very marked in some cases such as visual disorders: 55.9% (46.2-65.5) with MGA and 23.5% (15.3-31.8) with CH. There was poor concordance between MGA and CH. For example, neither the 73.3% (54.1-87.7) of the hearing disorders detected with the MGA, nor 94.1% (71.3-99.8) of the cognitive deterioration detected with the MGA had been previously recorded in the CH.
Conclusions:
MGA detects more health problems than are normally recorded in primary care clinical histories, which makes this technique relevant to PC consultations with the elderly. However, it would be advisable to identify the population for whom there was better diagnostic performance.