Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study

Abstract

ObjectivesHaving more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF.DesignIn this exploratory, cross-sectional study, a health professional conducted semi-structured interviews.SettingCommunity-dwelling older adults aged 75 and older in Germany.Participants65 participants (mean age=80.2, SD=3.6).Outcome measuresExtended ICF Checklist V.2.1a, patients prioritised chapters of the ‘activities and participation’ component.ResultsThe three most common impairments for ‘body functions’ were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For ‘body structures’, they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the ‘activities and participation’ component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the ‘mobility’ chapter as the most important of all chapters. ‘Environmental factors’ were facilitators of participants’ functioning.ConclusionsThis empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care.Trial registration detailsThe trial is registered in ClinicalTrials.gov (NCT03384732).

Laying the foundation for a primary care core set of the International Classification of Functioning, Disability and Health (ICF) for community-dwelling older adults: A qualitative study

“…“Mobility (d4)” played a major role for the participants. This is in accordance with the findings from our empirical study, which is also part of the ICF Core Set development process ( 35 ). Mobility is central to healthy ageing and independent living ( 10 , 36 ).…”

Development of a subset of the international classification of functioning, disability and health as a basis for a questionnaire for community-dwelling older adults aged 75 and above in primary care: a consensus study

“…The preparatory studies from the four perspectives each yielded different numbers and kinds of candidate categories of the ICF with some overlap but also differences. The systematic review identified 87,19 the patients’ perspective 189,18 the clinical perspective 8716 and the experts’ perspective 6717 second-level categories. Table 1 shows the number of categories in each ICF component that were identified in the individual preparatory studies 16–19…”

“…The preparatory phase was conducted as part of the project ‘Preventing Overdiagnosis in Primary Care’ (PRO PRICARE, German Federal Ministry of Education and Research, grant number: 01GY1605). A detailed report on the methods and analysis from each of the four preparatory studies can be found in the corresponding scientific publications 16–19…”

Indicators and Instruments to Assess Components of Disability in Community-Dwelling Older Adults: A Systematic Review

“…As the ICF conceptualizes disability as a health experience that occurs in a context, every domain should be assessed to look at medical, individual, social, and environmental influences on functioning and disability [ 97 ]. Different categories of older adults’ functioning have been studied [ 98 , 99 ], and some relevant ones have been proposed [ 100 , 101 ]. However, each domain has been assessed independently and, therefore, the integration of the ICF domains into single measures is needed [ 102 ].…”