A three year mortality study was undertaken of a population of 4490 people aged 65 and over in all types of hospitals and homes provided within a defined geographical area. The rate of survival consistently fell with increasing incapacity in mobility, incontinence, washing/dressing, and feeding. The effect was independent of differences in age, sex, and duration of stay. Differences in survival between patients and residents of National Health Service hospitals (geriatric, psychiatric, acute) and homes for the elderly did not persist after adjustment for variations between populations in level of incapacity, age, and sex. An assessment based on ability to perform basic items of self care is easily undertaken and understood by staff in different settings. It allows homogeneous groups of elderly people to be identified despite a diverse range of underlying diseases and could provide the basis for planning and evaluating services and rehabilitation regimens.
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