How do we classify functional status?

Abstract

The original question "How do we classify functional status?" is rephrased as "How do we order or arrange the limitations of function of primary care patients in classes?". After a review of the functions to be considered, the concept of functional status is presented using empirical data from the research project "Morbidity and Functional Status of the Elderly." The group studied consisted of 5,502 patients older than age 65 and 25 general practitioners in 12 practices. Functional status was assessed using five COOP charts: physical status, psychological status, daily activities, social status, and change. Morbidity was registered using the International Classification of Primary Care (ICPC). At the beginning and end of the study, 30% of the elderly patients assessed their physical functions as seriously limited, whereas 6% to 8% reported psychological problems and limitations in daily activities or social contacts. During the encounters, more serious limitations were recorded: 35% of encounters involved serious physical limitations; 18% involved serious limitations in activities of daily living, and 11% involved constant psychological problems or limitations in social contact. Women reported more physical limitations than men. Older patients reported more physical limitations than younger ones, and people living in nursing homes reported more limitations than patients living independently. From the disease-specific health profiles, we concluded that the greatest limitation of all aspects of function was scored during encounters for cerebrovascular disease, dementia, and cancer of the lung, stomach, intestine, and breast. Hypertension, "no disease," and "common cold" elicited the lowest functional limitations.(ABSTRACT TRUNCATED AT 250 WORDS)