Perceived health and geriatric risk stratification: observations from family practice

To examine the association between perceived health and self-reported presence of certain geriatric conditions. Perceived health (the way people rate their own health) is a summary measure of health status that predicts functional decline, health care use, and mortality, but has not been examined as a measure of the prevalence of key geriatric conditions among older adults.

Cross-sectional surveys addressing perceived health and other study variables were mailed to practice patients.

An urban university-based family medicine residency program.

In a random sample of 400 patients (from 1327 potential participants) older than 65 years (excluding those with known dementia), more than half (262) responded with usable surveys.

Self-reported geriatric syndromes, such as perceived memory loss, depression, falls, incontinence, weight loss, problems with walking, and difficulties with instrumental activities of daily living.

Of 262 respondents, 102 reported that they perceived their health as poor or fair and were much more likely than people who perceived their health as robust (good, very good, or excellent) to report memory impairment (49.6% vs 23.1%), depression (38.0% vs 13.5%), falls (26.5% vs 12.5%), incontinence (48.5% vs 34.6%), weight loss (33.3% vs 15.4%), needing help with walking (27.3% vs 13.1%), and difficulties with activities of daily living (57.6% vs 24.4%).

These results support the hypothesis that assessment of perceived health can help differentiate low-risk elderly people requiring usual surveillance for geriatric conditions from high-risk elderly people who require timely evaluation and management.