Instruments of functional assessment of elderly submitted to orthopedic surgery: an integrative review of literature

Abstract

Illnesses from muscles and skeleton, constitute the cause of functional damage of elderly. Nevertheless they are not inevitable consequences of age and they should be approached as specific illnesses rather then being regarded as result of aging. All aspects of health must be accounted for the measurement of the elderly health (Full Geriatric Assessment). Objective: To review the scientific publication dealing with the functional condition of elderly after subjected to orthopedic surgery. Material and Method: Bibliographic research on articles as per listing in the following databases www.bireme.br, www.ncbi.nlm.nih.gov/pubmed, www.scopus.com and www.embase.com covering a period from 1996 to 2006. It has been adopted the terminology as per Science of Health (DeCs/Birene) and at Medical Subject Headings (MeSH/PubMed) that identified the key-words: elderly, daily activity, orthopedic surgery or orthopedic procedures, post-surgery and rehabilitation. The search was carried out on April 2006 and the inclusion criterion was that the test subjects should be older than 60 and subjected to any orthopedic surgery procedure. The references meeting this criterion were listed and analyzed in EpiInfo version 3.3.2. The variables were: title, year and country of publication, professional categories of the authors, country of origin of the study, objective of the research, number of assessment tools, types of assessment tools, site of the surgery, full report available on line. Results: 44 abstracts have been selected among of which 29 were available as full reports. The Journal of the American Geriatric Society was the one that has published the largest number of articles dealing with this issue and the US was the country that has issued the greatest number of publication. 75% of the articles fitted within medical category, 79.3% of the studies are descriptive, 69% of the surgeries were on the hips and 27.6% of the searches employed only one assessment tool. Among the dimensions that have been evaluated 43.6% dealt with functional status while 30.8% were about mental status. Final Notes: The functional dimension was the most investigated while the social dimension was not contemplated. Although the number of publication is increasing in the last years, it’s necessary that health service starts to incorporate the new paradigm of functional evaluation of the elderly health.