[Health assessment of the elderly--a practical approach?]

Health assessment of elderly people as a routine procedure has been proposed in official reports and in the literature. Some programmes have been evaluated, including home visits and periodical health assessment programmes, but evaluation produces conflicting results. Whether health assessment of elderly people represents true or false safety depends on the association between risk factors and end points like mortality, morbidity, functional ability and quality of life. Who should be offered a health assessment, what should be the elements, and what is the scientific documentation for such an approach? Health assessment is of little value without follow-up. Periodic large-scale home visits or screening programmes are not recommended. Health assessment of old people at risk should be carried out by the general practitioner. The community has an obligation to plan for adequate medical services to prevent elderly people at risk to deteriorate without medical follow-up.