[The exhaustive geriatric evaluation in primary care: an assessment of its utility]

To describe the preliminary results from evaluating the application of an exhaustive geriatric evaluation procedure within primary care.

A descriptive crossover study of a non-random sample.

This was carried out in primary care at an out-station clinic serving a suburban population.

Those people aged 70 and over who requested health-care at the clinic. All the 131 people who attended between February and December 1992 were included in the procedure.

The Exhaustive Geriatric Evaluation was applied as an instrument to diagnose hidden health problems. The instrument is composed of functional classification (Katz and Lawton-Brody scales), detection of risk factors which might lead to institutionalisation and an exhaustive clinical assessment (biomedical, psychological and socio-family). The diagnostic usefulness of the procedure is 2.4 +/- 0.21 new diagnoses per patient, for 98% of those to whom the complete new procedure was applied (62.6% of the patients included). Problems of hypoacusis (33.3%), senile memory lapses (41.6%) and urinary incontinence (26.2%) were found to a significant degree (p < 0.05) compared with the previously diagnosed morbidity. On the Katz and Lawton-Brody scales, 74% and 41.9% of patients, respectively, were independent. 55.7% of patients presented at least one risk factor leading to institutionalisation, with loneliness being the most common (35.8% of cases).

The exhaustive geriatric evaluation is valid in primary care in looking after the elderly population, as it leads to the detection of functional and hidden bio-psychosocial problems.