STEP - Standardized assessment of elderly people in primary care
Background: There is a need for a standard preventive assessment scheme, which is effective,
feasible and acceptable throughout European primary care.
Methods: A consensus based guideline including systematic reviews of the evidence was
done by an expert panel of general practitioners (core group) and epidemiologists
/ geriatricians from seven European countries.
Results: The Step group identified 8 health domains to be considered in a preventive assessment;
client`s perspective and attitudes. physical state, functional state, significant
symptoms, mental function, social circumstances, medication and primary preventive
issues. To select the health areas with a proven preventive potential the strength
of scientific evidence and the relevance to primary preventive care was assessed.
The final recommendations graded as the preventive primary care impact factor
as follows: A1=strongly recommended were hypertension, symptomatic heart failure,
urinary incontinence, hearing impairment, vision impairment, falls, breathlessness,
depression, dementia, medication review, functional status, activity and physical
exercise. A2=recommended: Hypertension over the age of 80, history of myocardial
infarction, symptomatic coronary heart disease, atrial fibrillation, history of
TIA or stroke, peripheral vascular disease, diabetes, thyroid dysfunction, osteoporosis,
lipids, faecal incontinence, weight status, foot problems, oral heath, osteoarthritis,
sleeplessness, pain, social circumstances, tobacco and alcohol use, psychological
support for patients with chronic disease and (national) immunization & cancer
programms.
Conclusions: The rising population of elderly people in Europe gives cause for health care
professionals and policy makers to consider optimal ways to preserve health and
function in old age. An Evidence based, proactive preventive geriatric assessment
can help to promote heath and function in older people.
Keywords
Journal Article - Review - Europe - Meta-Analysis - Review, Academic - Activities
of Daily Living - Aged - Chronic Disease - Disabled Persons - Disease Progression
- Frail Elderly - Geriatric Assessment/methods - Guidelines - Health Priorities
- Human - Mass Screening/methods - Primary Prevention/methods - Public health
- Health Services for the Aged/statistics and numerical data - Mass Screening
- Support, Non-U.S. Gov't
