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Assessment of Appropriateness of Screening Community‐Dwelling Older People to Prevent Functional Decline
Author(s) -
Drewes Yvonne M.,
Gussekloo Jacobijn,
Meer Victor,
Rigter Henk,
Dekker Janny H.,
Goumans Marleen J. B. M.,
Metsemakers Job F. M.,
Overbeek Riki,
Rooij Sophia E.,
Schers Henk J.,
Schuurmans Marieke J.,
Sturmans Ferd,
Vries Kerst,
Westendorp Rudi G. J.,
Wind Annet W.,
Assendelft Willem J. J.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03775.x
Subject(s) - medicine , psychological intervention , gerontology , population , vulnerability (computing) , risk assessment , family medicine , environmental health , psychiatry , computer security , computer science
Objectives To identify appropriate screening conditions, stratified according to age and vulnerability, to prevent functional decline in older people. Design A RAND /University of C alifornia at L os A ngeles appropriateness method. Setting The N etherlands. Participants A multidisciplinary panel of 11 experts. Measurements The panelists assessed the appropriateness of screening for 29 conditions mentioned in guidelines from four countries, stratified according to age (60–74, 75–84, ≥85) and health status (general, vital, and vulnerable) and received a literature overview for each condition, including the guidelines and up‐to‐date literature. After an individual rating round, panelists discussed disagreements and performed a second individual rating. The median of the second ratings defined the appropriateness of screening. Results The panel rated screening to be appropriate in three of the 29 conditions, indicating that screening was expected to prevent functional decline. Screening for insufficient physical activity was considered appropriate for all three age and health groups. Screening for cardiovascular risk factors and smoking was considered appropriate for the general and vital population aged 60 to 74. Of the 261 ratings, 63 (24%) were classified as uncertain, of which 42 (67%) concerned the vulnerable population. The panelists considered conditions inappropriate mainly because of lack of an adequate screening tool or lack of evidence of effective interventions for positive screened persons. Conclusion The expert panel considered screening older people to prevent functional decline appropriate for insufficient physical activity and smoking and cardiovascular risk in specific groups. For other conditions, sufficient evidence does not support screening. Based on their experience, panelists expected benefit from developing tests and interventions, especially for vulnerable older people.