Disease ‐ Disability ‐ Mortality

To the t:ditor:-The article by Ford et all presents an interesting diseasedisability -mortality classification of the 12 leading conditions affecting the old and very old. The scheme seems to us of great value as a working hypothesis for those responsible for the treatment of the elderly and for the organization of various services. We applied the classification to the clinical data obtained by our group during two multidimensional epidemiological studies performed '1) in an elderly population living at home (1,201 subjects, 70-75 years old) and 2) in a nursing home (102 subjects, mean age 80 f 8). The results are reported in the table. The data of our research indicate that the groups of "severely disabled-nonlethal conditions" and "variably disabling-lethal conditions" have a higher prevalence in the nursing home, while the "less disabling-less lethal conditions" are evenly distributed in the nursing home and in the general population. Further efforts to collect more data and better interpretation of the results will be performed. However, it is possible to outline that the new classification confirms that nursing home residents, in comparison with the general elderly population, have more needs, both from the point of view of somatic health and from that of loss of self-sufficiency. The debate on the role of the medical component in the organization of nursing homes may be influenced by this reinterpretation of the data, further supporting previous clinical observations.