The majority of ambulatory older patients who visit primary care physicians are without severe disability. This group offers the greatest challenge and opportunity to identify functional deficits early enough to maintain optimal function and the ability to live independently as long as possible. 2 Simple evaluation of mobility and dexterity can identify those at greatest risk for falls or poor function, thereby offering the most timely and appropriate rehabilitative intervention to the most impaired patients. Vision changes in all of us as we age. If patients do not undergo periodic vision evaluations, quality of life suffers and the risk of falls increases.
Hearing is impaired in up to one half of all elderly persons.
Failure to identify hearing dysfunction can result in social isolation, depression and an overall decline in well-being. The early identification of cognitive decline has become imperative, with the availability of pharmacologic interventions shown to be of most value if started early in the course of decline. Early identification also allows frank discussions with the patient and family to allow realistic future planning. The diagnosis of depression allows physicians an opportunity to clinically and pharmacologically address a condition that, if left untreated, is likely to increase morbidity and mortality. Issues related to sexuality and to urinary continence have become topics of more frequent discussion in the lay media and the professional literature.