Zusammenfassung
In der vorliegenden Übersicht wird das multidimensionale geriatrische Assessments als mehrstufiger diagnostischer Prozess dargestellt: 1. Schritt – Screening zur Fallidentifikation, 2. Schritt – Basisassessment, 3. Schritt – vertieftes problemorientiertes Assessment. Aufgeführt werden Indikationen für ein geriatrisches Assessment und auch jene Situationen, in denen ein Assessment nicht indiziert ist. Ebenso werden die zu erfassenden Risikobereiche und die gängigsten Assessmentinstrumente dazu beschrieben. Ziel des diagnostischen Prozesses ist ein klarer Überblick über die individuellen Ressourcen und Defizite älterer Patienten. Das Ergebnis bietet eine rationale Grundlage für individuelle Entscheidungen in vielerlei Situationen ihrer medizinische Versorgung und Betreuung.
Abstract
This review presents comprehensive geriatric assessment as a diagnostic process in steps: step 1—geriatric screening for purposes of case finding, step 2—basic geriatric assessment, step 3—extended problem-centred assessment. The article specifies situations in which comprehensive geriatric assessment is recommended and when not, as well as the vital risk situations for geriatric patients and the respective appropriate assessment tools. The goal of the process is a clear overview of the specific resources and deficits of the elderly patient. The results provide a basis for rational individual decision-making in various medical issues.
Literatur
Lachs MS, Feinstein AR, Cooney LM Jr et al (1990) A simple procedure for general screening for functional disability in elderly patients. Ann intern Med 112:699–706
McCusker J, Bellavance F, Cardin S, Trépanier S (1998) Screening for geriatric problems in the emergency department: reliability and validity. Identification of Seniors at Risk (ISAR) Steering Committee. Acad Emerg Med 5(9):883–893
Thiem U, Greuel HW, Reingräber A et al (2012) Consensus for the identification of geriatric patients in the emergency care setting in Germany. Z Gerontol Geriatr 45:310–314
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9(3):179–186
Nikolaus T, Specht-Leible N, Bach M et al (1994) Soziale Aspekte bei Diagnostik und Therapie hochbetagter Patienten. Erste Erfahrungen mit einem neu entwickelten Fragebogen im Rahmen des geriatrischen Assessments. Z Gerontol Geriatr 27:240–245
Podsiadlo D, Richardson S (1991) The timed „Up & Go“: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148
Tinetti ME (1990) A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med 112:699–706
Scherfer E, Bohls C, Freiberger E, Heise KF, Hogan D (2006) Berg-Balance-Scale – deutsche Version. Physioscience 2(2):59–66
Guralnik JM, Ferrucci L, Simonsick EM et al (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332(9):556–561
Runge M, Rehfeld G (2001) Geriatrische Rehabilitation im therapeutischen Team, 2. Aufl. Thieme, Stuttgart
Folstein MF, Folstein SE, McMugh PR (1975) „Mini-Mental-State“: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Watson YI, Arfken CL, Birge SJ (1993) Clock completion: an objective screening test for dementia. J Am Geriatr Soc 41(11):1235–1240
Sunderland T, Hill JL, Mellow AM et al (1989) Clock drawing in Alzheimer’s disease. J Am Geriatr Soc 37(8):725–729
Strotzka S, Psota G, Sepandj A (2003) Uhrentest in der Demenzdiagnostik – auf der Suche nach der verlorenen Zeit. Psychopraxis 4:16–24
Kamenski G, Dorner T, Lawrence K et al (2009) Detection of dementia in primary care: comparison of the original and a modified Mini-Cog Assessment with the Mini Mental State Examination. Ment Health Fam Med 6:209–217
Yesavage JA, Brink TL, Rose TL et al (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 39:37–49
Lach HW, Chang YP, Edwards D (2010) Can older adults with dementia accurately report depression using brief forms? Reliability and validity of the Geriatric Depression Scale. J Gerontol Nurs 36(5):30–37
Rinaldi P, Mecocci P, Benedetti C et al (2003) Validation of the five-item geriatric depression scale in elderly subjects in three different settings. J Am Geriatr Soc 51(5):694–698
Mahoney Fi, Barthel Dw (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65
Lübke N et al (2004) Der Barthel-Index in der Geriatrie. Eine Kontextanalyse zum Hamburger Einstufungsmanual. Z Gerontol Geriatr 37:316–326
Daniels SK et al (1997) Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech-Language Pathology 6:17–24
Rubenstein LZ, Harker JO, Salva A et al (2001) Screening for undernutrition in geriatric practice: developing the short-form mini nutritional assessment (MNA-SF) J Gerontol 56A:M366–M377
Guigoz Y (2006) The Mini Nutritional Assessment (MNA©) review of the literature – What does it tell us? J Nutr Health Aging 10:466–487
Innoye SK et al (1990) Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Int Med 113:941–948
Schuurmans MJ, Shortridge-Bagett LM, DuursmaSA (2003) The delirium observation screening scale: a screening instrument for delirium. Res Theor Nurs Pract 17(1):31–50
Fried LP et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med 56(3):M146–M156
Ellis G, Whitehead MA, Robinson D, O’Neill D, Langhorne P (2011) Comprehensive geriatric assessment for older adults admitted to hospital: meta-analyses of randomised controlled trials. BMJ 343:d6553
Hamaker ME, Jonker JM, Rooij SE de et al (2012) Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol 13(10):437–444
Kammerlander C, Gosch M, Blauth M et al (2011) The Tyrolean geriatric fracture center: an orthogeriatric co-management model. Z Gerontol Geriatr 44(6)363–367
Kim KI, Park KH, Koo KH et al (2012) Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery. Arch Gerontol Geriatr 56(3):507–512
ArakiA, Ito H (2009) Diabetes mellitus and geriatric syndromes. Geriatr Gerontol Int 9(2):105–114
Pilotto A, Sancario D, Franceschi M et al (2010) A multidimensional approach to the geriatric patient with chronic kidney disease. J Nephrol 23(Suppl 15):S5–S10
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Sommeregger, U. Das multidimensionale geriatrische Assessment. Z Gerontol Geriat 46, 277–286 (2013). https://doi.org/10.1007/s00391-013-0473-0
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DOI: https://doi.org/10.1007/s00391-013-0473-0