Susan L. Hughes

Self Report and Performance-Based Hand Function Tests as Correlates of Dependency in the Elderly

Preventing or minimizing functional dependency in older adults rests, in part, upon the ability to predict who is at risk. The purpose of this study was to compare the ability of five tests of hand function to discriminate the degree of dependency in older adults. Seven hundred sixty four subjects were assessed for hand function on performance‐based (Williams Test of Hand Function, a test of Williams Board items only, Jebsen Test of Hand Function, grip strength), and self‐reported (Dexterity Scale of the Geriatrics‐Arthritis Impact Measurement Scale (GERI‐AIMS)) measures of hand function, and self‐reported multidimensional functional status (GERI‐AIMS). A trichotomous variable representing a continuum of dependency based upon living site (independent living, home‐bound, institutional) was used as the measure of dependency. Sixty‐two cases were dropped for incomplete data. Discriminant function analyses of the 702 subjects (age = 76.78 years, SD = 8.79) showed that basic demographic variables explain 40.8% of the variance in dependency; all hand function tests significantly correlated with dependency; the Williams Board correlated best (additional 12.5% variance explained). However, a multidimensional functional status measure explains substantially more variance in dependency (16.9%) after controlling for demographic variables and performance on the Williams Board. This comparison of methods and tests available for measuring hand function was made to provide criteria for selecting an instrument for a given setting.

Screening elderly veterans for alcoholism

Objective:To determine the sensitivity and specificity of an alcoholism screening test not previously tested in the elderly.Design:Cross-sectional study, face-to-face interviews.Setting:Veterans Administration (VA) outpatient facility.Patients/participants:Men ≥70 years old seeking care in a newly established VA outpatient facility were invited to participate in a health assessment program. Of 109 participants who enrolled, 96 completed both interviews.Interventions:The screening test was administered by an internist as part of a medical history. The Michigan Alcobolism Screening Test (MAST), used as the “gold standard,” was administered by a trained interviewer as part of a longer structured interview.Measurements and main results:The screening test had a sensitivity of 0.52 and a specificity of 0.76 in this sample.Conclusions:The sensitivity and specificity of the screening test were lower in this sample in comparison with previously reported results in a younger population. Differences in the test performance may be related to differences in attitudes and drinking behaviors of elderly veterans when compared with those of younger men and women.

Joint impairment and ambulation in the elderly

Objective: To test the impact of joint impairment on ambulation in the elderly, using a multivariate model.

Predictors of hand function in older persons : a two-year longitudinal analysis

OBJECTIVE: To validate a hierarchical model of hand function in older persons, using longitudinal data.