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November 10, 1993

Outcomes in Elderly Patients After Intensive Care

Author Affiliations

The Miriam Hospital Providence, RI

JAMA. 1993;270(18):2179. doi:10.1001/jama.1993.03510180049024

To the Editor.  —Chelluri and associates1 should be commended on their evaluation of the relationship between age and longterm outcome of intensive care patients. In a time when geriatricians are referring to the elderly in terms of youngold and old-old, it becomes clear that age alone is too crude a measure of functioning, and the thought that it might be used "as a criterion for allocating health care" is vaguely chilling.In looking at their choices for outcome measures, it is unfortunate that they did not choose to look specifically at neuropsychological functioning in their population. Quality of life, activities of daily living, and perhaps even depression, although related to cognitive functioning, are not predictive of it. Cognitive status testing may, on the other hand, be a more reliable predictor of those and other outcome measurements. With a number of well-validated mental status screens available (particularly in view of