Multidimensional Assessment of Elderly Patients

The most characteristic aspect of geriatric medicine is its multidimensional approach to the management of the complex problems of the frail elderly. Dysfunction of the elderly on several axes, organ dysfunction, neurobehavioral disorders, psychosocial impairment, and deterioration of social and economic supports all require accurate assessment for effective geriatric management and for prognosis, placement, and resource allocation. Intensive clinical investigation of the techniques, effectiveness, and cost of multidimensional geriatric assessment has resulted in the accumulation of considerable data, some difficult to interpret and apply to practical issues of health care. The physician team of Larry Z. and Lisa V. Rubenstein, who have contributed some of the clearest and best organized of these studies, reviews critically the methodology and applications of geriatric assessment in this article, which is of seminal importance to all clinicians who are charged with management of frail elderly patients.