The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community

OBJECTIVES: To develop a simple method for identifying community‐dwelling vulnerable older people, defined as persons age 65 and older at increased risk of death or functional decline. To assess whether self‐reported diagnoses and conditions add predictive ability to a function‐based survey.

[1]  R L Kane,et al.  Decreasing disability in the 21st century: the future effects of controlling six fatal and nonfatal conditions. , 1996, American journal of public health.

[2]  C. Winograd Targeting Strategies: An Overview of Criteria and Outcomes , 1991, Journal of the American Geriatrics Society.

[3]  T. Louis,et al.  Chronic conditions that lead to functional limitation in the elderly. , 1994, Journal of gerontology.

[4]  A. Jette,et al.  Health Status Assessment for Elderly Patients , 1989, Journal of the American Geriatrics Society.

[5]  F. Porell,et al.  The health status and utilization patterns of the elderly: implications for setting Medicare payments to HMOs. , 1989, Advances in Health Economics and Health Services Research.

[6]  S. Furner,et al.  Medical conditions differentially affect the development of IADL disability: implications for medical care and research. , 1995, The Gerontologist.

[7]  A. LaCroix,et al.  Coronary Disease Severity and Functional Impairment: How Strong Is the Relation? , 1996, Journal of the American Geriatrics Society.

[8]  S. Kasl,et al.  Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington counties, Iowa, 1982-1986. , 1990, American journal of epidemiology.

[9]  J. McMurray,et al.  Heart failure – implications of the true size of the problem , 1996, Journal of internal medicine.

[10]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[11]  L. Ried,et al.  Evaluation of a self-report screening instrument to predict frailty outcomes in aging populations. , 1997, The Gerontologist.

[12]  J Concato,et al.  Importance of functional measures in predicting mortality among older hospitalized patients. , 1998, JAMA.

[13]  M. Lawton,et al.  Assessment of older people: self-maintaining and instrumental activities of daily living. , 1969, The Gerontologist.

[14]  R A Kronmal,et al.  Risk factors for 5-year mortality in older adults: the Cardiovascular Health Study. , 1998, JAMA.

[15]  T. Obisesan,et al.  Moderate Wine Consumption Is Associated with Decreased Odds of Developing Age‐Related Macular Degeneration in NHANES‐1 , 1998, Journal of the American Geriatrics Society.

[16]  R. Harmer The high cost of dying , 1963 .

[17]  Jane S. Durch,et al.  Health Performance Measurement in the Public Sector: Principles and Policies for Implementing an Information Network , 1999 .

[18]  J. Sorkin,et al.  Serum albumin level and physical disability as predictors of mortality in older persons. , 1994, JAMA.

[19]  W. Strawbridge,et al.  Factors Associated with Change in Physical Functioning in the Elderly , 1993 .

[20]  K. N. Williams,et al.  Overview of adult health measures fielded in Rand's health insurance study. , 1979, Medical care.

[21]  J W Rowe,et al.  Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. , 1994, Journal of gerontology.

[22]  L. Rubenstein,et al.  The Association Between Chronic Illness and Functional Change Among Participants in a Comprehensive Geriatric Assessment Program , 1998, Journal of the American Geriatrics Society.

[23]  E. Palmore,et al.  Predictors of function among the old-old: a 10-year follow-up. , 1985, Journal of gerontology.

[24]  D J Foley,et al.  Co-morbidity analysis: a strategy for understanding mortality, disability and use of health care facilities of older people. , 1991, International journal of epidemiology.

[25]  P. Shekelle,et al.  Selecting Target Conditions for Quality of Care Improvement in Vulnerable Older Adults , 2000, Journal of the American Geriatrics Society.

[26]  W. Rakowski,et al.  Functional transitions among the elderly: patterns, predictors, and related hospital use. , 1994, American journal of public health.

[27]  R. Hays,et al.  Special issues addressed in the CAHPS survey of Medicare managed care beneficiaries. Consumer Assessment of Health Plans Study. , 1999, Medical care.

[28]  L. Rubenstein,et al.  The Use of Targeting Criteria in Hospitalized HMO Patients: Results from the Demonstration Phase of the Hospitalized Older Persons Evaluation (HOPE) Study , 1992, Journal of the American Geriatrics Society.

[29]  H. Agüero-Torres,et al.  Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study. , 1998, American journal of public health.

[30]  R. Weinstein,et al.  Marital status and health among the elderly. , 1995, Social science & medicine.

[31]  G. DeFriese,et al.  Predicting mortality from community surveys of older adults: the importance of self-rated functional ability. , 1997, The journals of gerontology. Series B, Psychological sciences and social sciences.

[32]  J. Murphy,et al.  Risk of functional decline among well elders. , 1989, Journal of clinical epidemiology.

[33]  J. F. Fitzgerald,et al.  The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study. , 1997, American journal of public health.

[34]  Outcomes‐Based Quality Improvement: Reducing the Data Collection Burden , 1998, Journal of the American Geriatrics Society.

[35]  D B Reuben,et al.  Value of functional status as a predictor of mortality: results of a prospective study. , 1992, The American journal of medicine.

[36]  J. Savarino,et al.  Predicting Hospitalization and Functional Decline in Older Health Plan Enrollees: Are Administrative Data as Accurate as Self‐Report? , 1998, Journal of the American Geriatrics Society.

[37]  A. Scitovsky "The high cost of dying" revisited. , 1994, The Milbank quarterly.

[38]  Predictive Validity of the Pra Instrument Among Older Recipients of Managed Care , 1997, Journal of the American Geriatrics Society.

[39]  L I Iezzoni,et al.  The risks of risk adjustment. , 1997, JAMA.

[40]  L. Rubenstein,et al.  Medicare capitation and quality of care for the frail elderly , 1986, Health care financing review.

[41]  I. Rosow,et al.  A Guttman health scale for the aged. , 1966, Journal of gerontology.

[42]  T. Seeman,et al.  The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging. , 1994, American journal of public health.

[43]  R. Hays,et al.  Identifying a short functional disability screen for older persons. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[44]  D. Bates,et al.  Paying more fairly for Medicare capitated care. , 1998, The New England journal of medicine.

[45]  R. Suzman,et al.  Longitudinal study of physical ability in the oldest-old. , 1989, American journal of public health.

[46]  S. Z. Nagi Some conceptual issues in disability and rehabilitation , 1965 .

[47]  A. McBean,et al.  Monitoring the health status and impact of treatment on Americans: the Medicare Beneficiary Health Status Registry. , 1999, Medical care.

[48]  W. Strawbridge,et al.  Negative consequences of hearing impairment in old age: a longitudinal analysis. , 2000, The Gerontologist.

[49]  Bonnie K. Lind,et al.  Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. , 1999, The New England journal of medicine.

[50]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[51]  E. Crimmins,et al.  Getting Better and Getting Worse , 1993 .

[52]  L. Rubenstein,et al.  Working Group Recommendations: Targeting Criteria for Geriatric Evaluation and Management Research , 1991, Journal of the American Geriatrics Society.

[53]  A. LaCroix,et al.  Morbidity and disability in older persons in the years prior to death. , 1991, American journal of public health.

[54]  E D Richardson,et al.  Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[55]  M. Ingber,et al.  Health Status of Medicare Enrollees in HMOs and Fee-for-Service in 1994 , 1996, Health care financing review.