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[Subjective need for help and objectified geriatric assess. Comparison of the Halberstädter Gerontologic Study and
N McGauran1, K Berger, B P Robra
1Institut für Sozialmedizin, Universität Magdeburg Leipzigerstr. 44, 39120 Magdeburg, Germany.
Abstract:
The Halberstadt Geriatric Study and the Augsburg Senior Citizens Study contain common elements of geriatric assessment (self-assessment of functional dependence, objective evaluation of the functional status). In our cross-sectional investigation, the objective was to examine associations between functional dependence and functional tests and to investigate whether association patterns differed between the surveyed groups. The prospective Halberstadt study began in the German Democratic Republic in 1983 within the framework of a vocational examination before employees entered retirement. In 1995 the study was reactivated; 367 survivors answered a postal questionnaire of which 167 persons took part in a test battery including performance and psychometric tests. The 214 Augsburg test persons had already taken part in the MONICA survey (monitoring of trends and determinants of cardiovascular disease). In 1997 they were assessed in a follow-up study, the aim being to determine the functional status of an elderly cohort through interviews and functional tests. In both studies functional dependence was defined by the (I)ADL concept [(instrumental) activities of daily living]. The participants' functional status was determined with the help of performance tests such as foot tapping and cognitive tests such as the Mini-Mental State Examination. Additionally, medical diagnoses and the use of medical facilities were investigated. The presence of functional dependence was consistently and predominantly significantly associated with the functional status assessed by performance tests. These results were largely confirmed by a logistic regression model. Our results show that even in populations with a different socialization, performance tests are stable indicators of functional dependence and should therefore be incorporated in geriatric assessment programs. The introduction of a standardized assessment program with subsequent intervention measures could lead to a delay of functional dependence and need of care and reduce costs in the health care system.