The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community
Top Cited Papers
- 1 December 2001
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 49 (12), 1691-1699
- https://doi.org/10.1046/j.1532-5415.2001.49281.x
Abstract
OBJECTIVES: To develop a simple method for identifying community-dwelling vulnerable older people, defined as persons age 65 and older at increased risk of death or functional decline. To assess whether self-reported diagnoses and conditions add predictive ability to a function-based survey. DESIGN: Analysis of longitudinal survey data. SETTING: A nationally representative community-based survey. PARTICIPANTS: Six thousand two hundred five Medicare beneficiaries age 65 and older. MEASUREMENTS: Bivariate and multivariate analyses of the Medicare Current Beneficiary Survey; development and comparison of scoring systems that use age, function, and self-reported diagnoses to predict future death and functional decline. RESULTS: A multivariate model using function, self-rated health, and age to predict death or functional decline was only slightly improved when self-reported diagnoses and conditions were included as predictors and was significantly better than a model using age plus self-reported diagnoses alone. These analyses provide the basis for a 13-item function-based scoring system that considers age, self-rated health, limitation in physical function, and functional disabilities. A score of ≥3 targeted 32% of this nationally representative sample as vulnerable. This targeted group had 4.2 times the risk of death or functional decline over a 2-year period compared with those with scores <3. The receiver operating characteristics curve had an area of .78. An alternative scoring system that included self-reported diagnoses did not substantially improve predictive ability when compared with a function-based scoring system. CONCLUSIONS: A function-based targeting system effectively and efficiently identifies older people at risk of functional decline and death. Self-reported diagnoses and conditions, when added to the system, do not enhance predictive ability. The function-based targeting system relies on self-report and is easily transported across care settings.Keywords
This publication has 51 references indexed in Scilit:
- Monitoring the Health Status and Impact of Treatment on AmericansMedical Care, 1999
- Impairments in Physical Performance and Cognitive Status as Predisposing Factors for Functional Dependence Among Nondisabled Older PersonsThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 1996
- Medical Conditions Differentially Affect the Development of IADL Disability: Implications for Medical Care and ResearchThe Gerontologist, 1995
- Marital status and health among the elderlySocial Science & Medicine (1982), 1995
- The disablement processSocial Science & Medicine (1982), 1994
- Factors Associated with Change in Physical Functioning in the ElderlyJournal of Aging and Health, 1993
- Getting Better and Getting WorseJournal of Aging and Health, 1993
- Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily LivingThe Gerontologist, 1969
- Studies of Illness in the AgedJAMA, 1963