Assessment of Appropriateness of Screening Community-Dwelling Older People to Prevent Functional Decline

YM Drewes, J Gussekloo, V van der Meer, HGM Rigter, JH Dekker, MJBM Goumans, JFM Metsemakers, R van Overbeek, SE de Rooij, HJ Schers, MJ Schuurmans, F (Ferd) Sturmans, Karin Vries, RGJ Westendorp, AW Wind, WJJ Assendelft

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Abstract

OBJECTIVES: To identify appropriate screening conditions, stratified according to age and vulnerability, to prevent functional decline in older people. DESIGN: A RAND/University of California at Los Angeles appropriateness method. SETTING: The Netherlands. 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 appr 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 po 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. J Am Geriatr Soc 60:42-50, 2012.
Original languageUndefined/Unknown
Pages (from-to)42-50
Number of pages9
JournalJournal of American Geriatrics Society
Volume60
Issue number1
DOIs
Publication statusPublished - 2012

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