Standard assessment scales for elderly people. Recommendations of the Royal College of Physicians of London and the British Geriatrics Society.

Sir,-In 1989 the Research Unit of the Royal College of Physicians initiated a workshop to consider scales that could be recommended for the assessment of elderly people in geriatric medicine services. At the outset, the main motive behind this initiative was to provide the tools for part of a minimum dataset in geriatric medicine. The workshop was convened in association with the British Geriatrics Society and included participants drawn from associated professions. At the workshops, precirculated expert papers were presented briefly and discussed in detail. Topics included the individual assessment domains , the science of assessment, the interface with primary care, and the ethics of assessment. The assessment domains that were considered comprised activities of daily living, communication, mood, cognitive function, social status, and quality of life. Between the workshops, each domain was the subject of consideration in much greater detail by smaller working groups drawn from among workshop participants. The background papers, minutes of workshop discussions, results of the deliberations of the small working groups, and other miscellaneous comments were incorporated into a report which was published this year.' The report includes background comments on standard assessments and provides the rationale for assessment in each domain. A standard scale is recommended for each domain (table) and potential areas for future research are highlighted. The report reproduces the individual scales along with any instructions for the ones that are available. In general, the scales recommended are simple and well established. For activities of daily living, the Barthel ADL Index probably reflects existing informal assessments and formalises existing activities, while the scale for cognitive impairment-the Abbreviated Mental Test-is probably in widespread use already. The mood and morale scales are probably less familiar although recognising depression is clearly good practice. Particular difficulty was encountered in recommending a scale for measuring social status, Recommended assessments scales for elderly people. Primary ADL Memory Communication Mood Morale Social status partly because social status has so many different aspects. Instead, a simple social checklist has been proposed. The workshops and report have been accompanied by a parallel research project-the SAFE (standard assessment for the elderly) study. This consisted of a multicentre evaluation of the use of the recommended scales in the real world. Data are currently being analysed and reports should be available later this year. Participants in this study, which was cofunded by seed money from the Research Unit of the Royal College of Physicians …