Health testing in the elderly by the multiphasic method

A multiphasic screening programme was carried out on a stratified sample of the elderly population of a small town in Israel. The purpose was to gain an assessment of the health profile of the subjects and to estimate what kind of community geriatric services might be required. The performance of the programme in 3 days on 89% of the 200 subjects who were available testified to the rapidity and yield of information by this 'conveyor-belt' system of examination. The technique is described, and some criticisms and suggestions are advanced. Evaluation of the efficacy of this method of screening was judged on four types of information accruing in a survey of the elderly. Demographic and epidemiological data, together with prevalence of symptoms or clinical signs and their correlations could be rapidly ascertained; so also could specific pathologic parameters be rapidly collected, which required medical follow-up, such as blood sugar values. The method appeared less successful in assessing an individual's functional or social difficulties which would require specific community services because of the multi-facetted type of examination by different members of the team. Similarly, a screening programme which depends on its subjects being transported may miss some of the more infirm people, as was subsequently found in this survey. It is concluded that for the elderly, the multiphasic method with the expense and organisation required is appropriate for preliminary screening of a section of a population, or for the screening of selective groups at risk.