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March 1987

Exposing the Iceberg of Unrecognized Disability: The Benefits of Functional Assessment of the Elderly

Author Affiliations

UCLA School of Medicine Sepulveda (Calif) Veterans Administration Medical Center 16111 Plummer St Sepulveda, CA 91343

Arch Intern Med. 1987;147(3):419-420. doi:10.1001/archinte.1987.00370030023004

For many years, specialists in geriatric medicine have advocated the practice of comprehensive assessment of frail, elderly patients. Such assessment goes beyond the usual medical workup in that specific tests of physical function, cognition, affect, and the social support system are performed. Interdisciplinary teams are often used. Evidence that elderly patients can benefit from such comprehensive assessment has been emerging since the 1940s, first from British geriatricians and more recently from the United States and Canada.1-4 Benefit from geriatric assessment seems to derive from enhanced awareness of and better focusing on a patient's treatable disabilities together with augmented ability to arrange for specific care and follow-up.

In the present issue, Pinholt and her colleagues5 report results of a careful study that compares the sensitivity of formal geriatric assessment with judgment of the primary care hospital physician in diagnosing functional disability such as mental impairments, visual dysfunction, and incontinence among hospitalized