Abstract
Background. Disability in elderly people increases with advancing age, polymorbidity and presence of geriatric syndromes.
It negatively influences health status, quality of life and has negative social and economic consequences. Therefore, seniors with disability should be identified and their disability quantified.
In the Czech Republic a pilot study with international WHODAS 2.0 tool was conducted for the first time evaluating feasibility and usability of this tool in ambulatory geriatric out-patients in a WHODAS-GERI joint project of the Institute of Health Information and Statistics of the Czech Republic and Czech Society of Gerontology and Geriatrics, Czech Medical Association. Patients and methods.
Prospective assessment of 104 patients of geriatric clinics in 9 centres, evaluation of disability level using WHODAS 2.0 questionnaire (36 items), self-sufficiency and independence using ADL and IADL tests and cognitive impairment using MMSE test; complementing questionnaire survey in geriatricians performing the assessment. Results.
Extent and severity of the overall disability and of the 6 WHODAS 2.0 based domains correlate well with a total scores of functional tests ADL, IADL and MMSE, routinely used as part of comprehensive geriatric assessment. In some domains (interactions with other people, participation in social activities) WHODAS 2.0 provides information which are unknown/not routinely collected.
This finding was supported by responses of participating physicians. However, their view on usability is rather cautious as for some patients completion of questionnaire was difficult, for low specificity of some domains and limits for direct use of the results for social allowances eligibility.
Conclusions. WHODAS 2.0 seems to be a valid instrument for disability level in geriatric out-patients.
Its use is supported when the comprehensive geriatric assessment and evaluation of the functional status and limitations cannot be performed, in selected groups of seniors with chronic conditions and if broader evaluation of quality of life is beneficial. In the future, larger epidemiologic population studies in seniors are needed to gain normative WHODAS 2.0 data, disability prevalence and for use of these information to design preventive programs to reduce dependency level of dependence in older people.