Skip to main content
Log in

Das multidimensionale geriatrische Assessment

The multidimensional geriatric assessment

  • CME Zertifizierte Fortbildung
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. 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

    PubMed  CAS  Google Scholar 

  2. 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

    Article  PubMed  CAS  Google Scholar 

  3. 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

    Article  PubMed  CAS  Google Scholar 

  4. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9(3):179–186

    Article  PubMed  CAS  Google Scholar 

  5. 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

    CAS  Google Scholar 

  6. 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

    PubMed  CAS  Google Scholar 

  7. Tinetti ME (1990) A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med 112:699–706

    PubMed  Google Scholar 

  8. Scherfer E, Bohls C, Freiberger E, Heise KF, Hogan D (2006) Berg-Balance-Scale – deutsche Version. Physioscience 2(2):59–66

    Article  Google Scholar 

  9. 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

    Article  PubMed  CAS  Google Scholar 

  10. Runge M, Rehfeld G (2001) Geriatrische Rehabilitation im therapeutischen Team, 2. Aufl. Thieme, Stuttgart

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. Watson YI, Arfken CL, Birge SJ (1993) Clock completion: an objective screening test for dementia. J Am Geriatr Soc 41(11):1235–1240

    PubMed  CAS  Google Scholar 

  13. Sunderland T, Hill JL, Mellow AM et al (1989) Clock drawing in Alzheimer’s disease. J Am Geriatr Soc 37(8):725–729

    PubMed  CAS  Google Scholar 

  14. Strotzka S, Psota G, Sepandj A (2003) Uhrentest in der Demenzdiagnostik – auf der Suche nach der verlorenen Zeit. Psychopraxis 4:16–24

    Google Scholar 

  15. 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

    PubMed  Google Scholar 

  16. 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

    Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. Mahoney Fi, Barthel Dw (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65

    PubMed  CAS  Google Scholar 

  20. Lübke N et al (2004) Der Barthel-Index in der Geriatrie. Eine Kontextanalyse zum Hamburger Einstufungsmanual. Z Gerontol Geriatr 37:316–326

    Article  PubMed  Google Scholar 

  21. Daniels SK et al (1997) Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech-Language Pathology 6:17–24

    Google Scholar 

  22. 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

    Google Scholar 

  23. Guigoz Y (2006) The Mini Nutritional Assessment (MNA©) review of the literature – What does it tell us? J Nutr Health Aging 10:466–487

    PubMed  CAS  Google Scholar 

  24. Innoye SK et al (1990) Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Int Med 113:941–948

    Google Scholar 

  25. 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

    Article  Google Scholar 

  26. Fried LP et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med 56(3):M146–M156

    Article  CAS  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    Article  Google Scholar 

  29. 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

    Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. ArakiA, Ito H (2009) Diabetes mellitus and geriatric syndromes. Geriatr Gerontol Int 9(2):105–114

    Article  Google Scholar 

  32. 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

    PubMed  Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to U. Sommeregger.

Zusatzmaterial online

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sommeregger, U. Das multidimensionale geriatrische Assessment. Z Gerontol Geriat 46, 277–286 (2013). https://doi.org/10.1007/s00391-013-0473-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-013-0473-0

Schlüsselwörter

Keywords

Navigation