{'fraction_non_alphanumeric': 0.022241231822070145, 'fraction_numerical': 0.003849443969204448, 'mean_word_length': 5.012853470437018, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Brief Screening of the Elderly

In this issue, Dr. Gerda G. Fillenbaum describes the development of a brief screening instrument to assess instrumental activities of daily living (IADL). The screening instrument consists of five items: 1) can get to places out of walking distance, 2) can go shopping for grocery or clothes, 3) can prepare own meals, 4) can do housework, and 5) can handle own money. Summing inabilities in the five activities generates a score that, as discussed in the article, is not only associated with physical and mental status but also with consequent deterioration. This excellent brief screening instrument thus has both discriminant and predictive validity. Given the soundness of this instrument, the questions that clinicians must ask concerns the utility for them of this brief screening instrument. Its simplicity can make one dubious regarding the quality of the information. Yet, its simplicity is a virtue making it an easy way for health professionals to communicate. Moreover, beyond usefulness for differentiating among patients on initial contact, this simple IADL instrument can be used to chart change. To the extent that a purpose of treatment is the improvement of functioning in everyday life, the items identify general goals to achieve. Whereas for some geriatric patients it is unlikely that an immediate concern will be returning the patient to activities of daily living (eg, those in intensive care units), for most patients this concern will be a primary goal. We‘ have reported on the usefulness of such an instrument; that is, a forerunner of the Fillenbaum instrument, the brief six-question self-care inventory developed by Dr. Ethel When following a sample of 85 elderly persons from preto postinstitutionalization in homes for the aged, we found that after admission these individuals reported less ability for self-care. From all other available data, however, it was apparent that their mental and physical status had not changed SUEciently to account for the deterioration. From still other data gathered in 12 to l G hours of interviewing, such as on body preoccupation, it became apparent that the change was a function of becoming a patient among others in a nursing home. The sensitivity of this kind of brief screening instrument in detecting deleterious iatrogenic effects