57 tests for problems of the elderly

Treating diseases of the elderly does not make any sense if age-related limitations are not taken into account. Identifying them is the task of geriatric assessment. The updated guidance provides an overview.

Older people can be treated more successfully if their physical, mental and emotional state is taken into account. British physician Marjorie Warren was the first to record these factors systematically. From 1943 onwards, she published and justified her observations geriatrics. Since then, countless methods have been developed to determine the condition of the elderly. Geriatric evaluation became the standard in the 1980s when its benefits in improving care were demonstrated. The growth in new procedures continues to be so great that it is nearly 100 pages long Guideline for geriatric assessment level 2 It was designed as a living guideline – the latest edition was published this year.

The guideline hardly provides any data on the evidence basis for the procedures because there are few corresponding studies. It also emphasizes that the list of procedures mentioned is not exhaustive and that procedures not mentioned may also be useful. The guidelines were developed under the leadership of the German Geriatrics Society and agreed upon in the distribution process. Those addressed are everyone who cares for people in aged care facilities – not just doctors.

The second level covers 11 regions

the Geriatric assessment It has three levels: Level 1 deals with the question of whether someone is merely old or already ill in old age. The second stage aims to identify the nature and extent of the problems. In Stage 3, disabilities are further demonstrated. The guideline discusses Level 2 procedures, although the boundaries are not clear-cut. This is how a general practitioner does it – the basic geriatric assessment (Republican Party 03360) As level 1, on the one hand, the function of geriatric examination, on the other hand, the family doctor can already specifically identify problems related to his previous knowledge, which means fulfilling the features of level 2.

The guideline discusses a total of 57 measures in 11 domains: vision/hearing, self-help ability, motor/motor skills, cognitive assessment/delirium, depression, marital status, pain, feeding/dysphagia, self-control, sleep, and substance use. addicted. The distribution of actions varies greatly. The area of ​​social situation, for example, is only described in a short section without measures because factors such as living situation, contacts, social activities, aids needed and available, nursing support as well as legal orders are not fully covered by the two well-known social questionnaires, and thus mainly internal instruments are used.

15 procedures in the field of perception

However, in the field of cognition, the authors present 15 different measures: from the quick and simple six-item examination (SIS) of registration status to Mini mental status examination (MMSE), which is the most widely used worldwide for diagnosing clinical dementia, is based on the evolving Global Deterioration Scale (GDS). You can see the complexity of some of the procedures by the fact that the instructions alone list five different monitoring tests.

The procedures are described together for each area and then described individually in standardized tables. The following points are listed in the table: average time required, learning effort of researchers, study operators, intensity, quality criteria, justification for inclusion in guidelines, limitations/need for research and literature. It is not described how the procedures actually work, which questions are included in the survey questionnaire, for example, or which tasks need to be completed in the MMSE.

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