Prognosis for Functional Deterioration and Functional Improvement in Late Life Among Community-Dwelling Older Persons

摘要

The article by Stineman et al [1] in this issue of PM&R revisits the topic of the relationships among change in functional status, chronic disease burden, and mortality in older adults. We have witnessed many developments in the topic of functional assessment in older adults during the past decade, such as the characterizations of trajectories of decline approaching mortality [2] and the development of physical function staging tools by several different groups [3], including an activities of daily living (ADL) staging system developed previously by Stineman and her collaborators [4]. Stineman et al's ADL staging system was credited as intellectual progress toward something referred to as the Functional Reserve Assessment Map for Elders (FRAME), an as-of-yet unidentified staging system that has been called for and that would characterize functional status in older adults, in a manner similar to that of the 4-stage heart failure classification, to help us better understand functional decline and to identify effective interventions [3].