[Development of comprehensive assessment system for elderly patients in a geriatric hospital]

Studies in the United States and Europe revealed that a comprehensive geriatric assessment is useful in the management and treatment of elderly disabled patients. In Japan, there are few reports of the development of such assessment. We examined the reliability of a scale designed to assess the performance of activities of daily living (ADL), a revised version of Hasegawa's Dementia Scale) HDSR, and a depression scale (GDS-15), using results from 140 patients over 65 years old who were admitted to our hospital from the end of January to early February 1994. The reliabilities of the ADL and HDSR scales were acceptable, but the kappa value of the GDS-15 was very low. The ADL score was low in patients with cerebrovascular diseases, dementia, and bone and joint problems, but the HDSR score was not low in the latter group. These results suggest that each disease has a characteristic pattern of impairments and disabilities. Although psychological assessment is essential and requires validation, a prospective study of outcomes in the evaluated elderly patients might also be fruitful.