高齢患者における機能障害の一般的スクリーニングのための簡易手順

M S Lachs1, A R Feinstein, L M Cooney

  • 1Yale University School of Medicine, New Haven, Connecticut.

PubMed

我々は、一般内科医が外来診療において高齢患者の機能状態を日常的にスクリーニングするために利用できる、簡便で短時間のアプローチを提案する。このアプローチは、高齢患者に対して従来の病歴聴取や身体診察を行う際に見落とされがちであるが、機能不全に陥りやすい限定的な数の項目を確認することに基づいている。新たな重点項目は、慎重に選択された視力、聴力、上肢および下肢機能、尿失禁、精神状態、手段的および基本的日常生活動作、環境的危険要因、ならびに社会的支援システムに関する検査である。簡潔な質問と容易に観察可能なタスクを用いることで、実施時間を最小限に抑えつつ、適切かつ効果的なスクリーニングに必要な情報を取得する。日常的な臨床検査から相対的に生産性の低い特定の処置を排除し、特に内科医に追加時間に対する適切な報酬が支払われれば、このアプローチを日常診療に組み込むことが可能である。

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