13. Studies in rating the physical, mental, and social dysfunction of the chronically ill aged

It is difficult to separate what might be considered the normal from the dysfunctional aspects of aging in the physical, mental, and social areas, and wide variation occurs in the way persons age, with and without chronic illness. One cannot, and would not want to, disentangle these interrelated areas, but they are often measured as if they were independent of each other. Any assessment of the total functioning of an individual must take into account the subject's own perception of his health or functional status which, in addition to the cultural influences and feedback from the environment, interact to produce total adjustment. There is some indication that self-assessments of health may be a reliable predictor of more detailed functional assessments. Lastly, there is a plea for the study of a multidimensional approach including objective and subjective physical, mental, and social measurements related to patient outcome. With currently available statistical methods, it may be possible to reduce the number of variables needed for assessment of the total person to a few that uniquely describe overall status.