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Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie 2/2015

01-04-2015

Een gevalideerd screeningsinstrument voorspelt functieverlies bij thuiswonende ouderen: de Identification of Seniors at Risk – Primary Care (ISAR-PC)

Auteurs: Jacqueline J. Suijker, Bianca M. Buurman, Marjon van Rijn, Marlies T. van Dalen, Gerben ter Riet, Nan van Geloven, Rob J. de Haan, Eric P. Moll van Charante, Sophia E. de Rooij

Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie | Uitgave 2/2015

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Samenvatting

Achtergrond

Bij thuiswonende ouderen wordt functieverlies mogelijk uitgesteld door preventieve interventies. Het herkennen van ouderen met een verhoogd risico op functieverlies is een belangrijke eerste stap. Dit onderzoek heeft als doelstellingen: (1) om het Identification of Seniors At Risk (ISAR) screeningsinstrument te optimaliseren en te valideren in een eerstelijnspopulatie (ISAR-Primary Care) en (2) om selectie van ouderen met verhoogd risico, vastgesteld met behulp van de ISAR-PC te vergelijken met selectie op basis van alleen leeftijd.

Methode

In de prospectieve ontwikkelings- en validatiecohorten namen respectievelijk 790 en 2573 thuiswonende ouderen ( 70 jaar) deel. Functieverlies was gedefinieerd als minimaal één punt achteruitgang op de gemodificeerde Katz-activiteiten van de dagelijks leven index na twaalf maanden ten opzichte van de score bij inclusie, dan wel sterfte.

Resultaten

Drie diagnostische kenmerken waren het meest voorspellend voor functieverlies: leeftijd (odds ratio (OR) 1,06 per toegevoegd jaar; 95 %- BI = 1,02–1,10), afhankelijkheid bij instrumentele activiteiten van het dagelijks leven (OR = 2,17; 95 %-BI = 1,46–3,22), en geheugenproblemen (OR = 2,22; 95 %-BI = 1,41–3,51). Het onderscheidend vermogen uitgedrukt in de AUC-range van de ISAR-PC was 0,67–0,70, en de kalibratie was goed. Van de deelnemende ouderen werd 40,6 % geclassificeerd als ouderen met een verhoogd risico op functieverlies. In het validatiecohort was de AUC range 0,63–0,64. De AUC range van leeftijd ≥ 75 jaar alleen in het validatiecohort was 0,56–0,57 en 65,0 % van de deelnemende ouderen werd daarbij geclassificeerd met een verhoogd risico op functieverlies.

Conclusie

Het discriminerend vermogen van de ISAR-PC is redelijk en de kalibratie goed. Selectie van ouderen met een verhoogd risico op functieverlies op basis van ISAR-PC is efficiënter dan selectie op basis van alleen leeftijd.
Bijlagen
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Metagegevens
Titel
Een gevalideerd screeningsinstrument voorspelt functieverlies bij thuiswonende ouderen: de Identification of Seniors at Risk – Primary Care (ISAR-PC)
Auteurs
Jacqueline J. Suijker
Bianca M. Buurman
Marjon van Rijn
Marlies T. van Dalen
Gerben ter Riet
Nan van Geloven
Rob J. de Haan
Eric P. Moll van Charante
Sophia E. de Rooij
Publicatiedatum
01-04-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Gerontologie en Geriatrie / Uitgave 2/2015
Print ISSN: 0167-9228
Elektronisch ISSN: 1875-6832
DOI
https://doi.org/10.1007/s12439-015-0128-2

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