Eorts

for early detec/on of geriatric problems in the elderly at the primary care clinic by 10-min comprehensive screening
Daisuke Son, Takamasa Watanabe, Yasuki Fujinuma
Centre for Family Medicine Development (CFMD), HeW Co-op Japan
Objec/ve
Elderly pa=ents are facing mul=ple and complex health problems, and making diagnosis of them within a limited =me is oFen dicult in clinical prac=ce. Because many of the problems are chronic, it is important to diagnose and treat them earlier. The screening project of geriatric giants" (cogni/ve impairment, urinary incon/nence, depression, instability) was conducted over 5 months to all the regularly visi=ng outpa=ents over the age of 70 at the local primary care clinic in Tokyo, Japan.

Methods
Targeted people were all the pa=ents with chronic diseases over the age of 70 who visited our clinic regularly (about 150 pa=ents), and the screening was done during 5 months from August to December 2010. Doctors asked pa=ents consent for screening test at the end of the consulta=on, and to whom the consent was obtained, one of the sta (doctor, nurse or clinical clerk) conducted the 10-minute comprehensive screening using a ques=onnaire. The ques=onnaire was cited from Age- Friendly Primary Health Care Centres Toolkit" developed by WHO.

10-min comprehensive screening ques=onnaire (from WHOs Age-Friendly PHC Toolkit)

Results
The screening ques=onnaires were conducted with 136 elderly pa=ents in ve months. The mean age was 77.1 years old (SD 6.0). By the cogni/ve impairment screening conducted by a three-word recall method, 20% (27/136) recalled only one word or less in three words, and among them 6% (8/136) were newly detected and cared. For urinary incon/nence, 13% (18/136) reported urine leakage within the last week, and among them 2% (3/136) were newly detected and cared. Depressive mood was observed in 22% (30/136), and 6% (8/136) were newly recognized and cared. Gait instability or history of fall was observed in 24% (33/136), and 2% (3/136) were newly recognized and cared.
cogni/ve impairment urinary incon/nence

6% 14% 80%
depressive mood

2% 11%

newly detected exis=ng symptom no symptom

Disucussion
Among elderly pa=ents over the age of 70 in our outpa=ent clinic, geriatric problems were found at least in 13% to 24% by the screening ques=onnaire, and some pa=ents were newly diagnosed and followed up for care. This screening method using a simple structured ques=onnaire has an advantage that can be carried out simply and shortly in the clinical prac=ce, which leads to eec=ve early detec=on of geriatric problems in the elderly pa=ents.

87%
gait instability

6% 16% 78%

2% 22% 76%

prevalence of each geriatric problems detected by 10-min comprehensive screening