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Assessment of the effectiveness of an instrument to identify health and social problems in an elderly population from a primary health care center

Abstract:

Objective. To assess the response rate to a multidimensional, self administered questionnaire in patients ≥75 years old attending a primary health care center and to establish the prevalences of problems in the following dimensions: socioeconomical, cognitive, morbidity, polypharmacy, physical activity, falls, and activities of the daily living. Design. Cross-sectional descriptive study based on a self-administered questionnaire posted by mail. Setting. A primary health care center in Barcelona. Spain. Participants. A total of 1299 patients ≥75 years old. Main measurements. Social surroundings, activities of the daily living, sensorial problems, morbidity, physical symptoms including sphincters incontinence, cognitive status, and medication use. Results. The response rate was 68% (95% CI, 0.65-0.70). The average age of the women who participated was significantly greater than the one of the men (82.5±5.3 vs 81.6±5.0, respectively). A significantly greater proportion of women than of men lived single (38.2 vs 10.9%); they had difficulties to maintain its house cosy (15.6 vs 8.8%) and they had difficulties to make ends meet (18.0 vs 13.6%). Globally, there were a greater proportion of women than of men whom they had: medical problems, cognitive problems, depression, and difficulties to carry out activities of the daily living. Overall, subjects that have had difficulties to make ends meet had greater prevalences of problems in all the dimensions of this evaluation. On the other hand, subjects that lived single had lower prevalences of problems in all the dimensions except they had a greater prevalence of depression. Conclusion. The multidimensional evaluation in elderly patients by the postal method is an efficient procedure that allows identifying many socioeconomic and health problems. In addition, it is feasible to identify to most fragile subjects and latter on to carry out preventive and curative interventions on them as well as to make their follow up.