Skip to main content
SpringerLink
Log in

The development of a new tool for the evaluation of handicap in elderly: the Geriatric Handicap Scale (GHS)

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

To date, the comprehensive geriatric assessment (CGA) does not include an evaluation tool for handicap.

Aim

To develop a new instrument for assessing handicap in the elderly: the Geriatric Handicap Scale (GHS).

Methods

656 community-dwelling elderly were enrolled in this study. We identified the thematic areas investigated by the CGA which showed a significant correlation with the handicap condition (handicap yes/not) to be included in our scale (Phase 1). Afterwards, we evaluated the possible correlations between: (1) the score obtained in each area of GHS and those obtained in CGA tests investigating similar dimensions, (2) GHS total score and the Multidimensional Prognostic Index (MPI) total score (Phase 2).

Results

In Phase 1, data analysis showed several significant correlations between the handicap condition and the scores obtained to the CGA tests exploring cognition, mood, functional impairment, comorbidity, social and environmental variables. Thus, we developed a tool considering five variables: (1) cognition and mood; (2) functional impairment; (3) hearing/visual impairment; (4) any additional comorbidity factors; (5) environmental/social risk factors. In Phase 2, data analysis showed significant correlations between the score obtained in each area of GHS and those obtained in the CGA tests investigating similar dimensions. A positive correlation between GHS total score and MPI total score (r = 68; p = 0.001) was also reported. Cut-off score for the GHS was established. Psychometric properties of GHS were also investigated and adequate estimates of internal reliability were demonstrated.

Conclusions

Our tool could prove useful to correctly categorize the disadvantageous condition related to patient’s disability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Buckinx F, Rolland Y, Reginster J et al (2015) Burden of frailty in the elderly population: perspectives for a public health challenge. Arch Public Health 73:19. https://doi.org/10.1186/s13690-015-0068-x

    Article  PubMed  PubMed Central  Google Scholar 

  2. de Vries NM, Staal JB, van Ravensberg CD et al (2011) Outcome instruments to measure frailty: a systematic review. Ageing Res Rev 10:104–114. https://doi.org/10.1016/j.arr.2010.09.001

    Article  PubMed  Google Scholar 

  3. World Health Organization (1980) International classification of impairments, disabilities, and handicaps. Geneva: WHO

  4. Badley EM (1987) The ICIDH: format, application in different settings, and distinction between disability and handicap. A critique of papers on the application on the international classification of impairments, disabilities, and handicaps. Int Disabil Stud 9:122–125

    Article  CAS  Google Scholar 

  5. World Health Organization (2001) International Classification of Functioning, Disability and Health (ICF) Geneva: WHO

  6. Pilotto A, Cella A, Pilotto A et al (2017) Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc 18:192.e1–192.e11. https://doi.org/10.1016/j.jamda.2016.11.004

    Article  Google Scholar 

  7. Panza F, Solfrizzi V, Lozupone M et al. (2017) An old challenge with new promises: a systematic review on comprehensive geriatric assessment in long-term care facilities. Rejuvenation Res. https://doi.org/10.1089/rej.2017.1964

    Article  PubMed  Google Scholar 

  8. Ventry IM, Weinstein BE (1982) The hearing handicap inventory for the elderly: a new tool. Ear Hear 3:128–134

    Article  CAS  Google Scholar 

  9. Florian Zeman M, Koller M, Schecklmann et al. (2012) Tinnitus assessment by means of standardized self-report questionnaires: psychometric properties of the tinnitus questionnaire (TQ), the Tinnitus Handicap Inventory (THI), and their short versions in an international and multi-lingual sample Health Qual Life Outcomes; vol. 10, p 128

    Article  Google Scholar 

  10. Mouthon L, Rannou F, Bérezné A et al (2007) Development and validation of a scale for mouth handicap in systemic sclerosis: the mouth handicap in systemic sclerosis scale. Ann Rheum Dis 66:1651–1655

    Article  CAS  Google Scholar 

  11. Bamford JM, Sandercock PA, Warlow CP et al (1989) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 20:828

    Article  CAS  Google Scholar 

  12. Pilotto A, Ferrucci L, Franceschi M et al (2008) Development and validation of a multidimensional prognostic index for 1-year mortality from the comprehensive geriatric assessment in hospitalized older patients. Rejuvenation Res 11:151–161

    Article  Google Scholar 

  13. Pilotto A, Rengo F, Marchionni N et al (2012) Comparing the prognostic accuracy for all-cause mortality of frailty instruments: a multicentre 1-year follow-up in hospitalized older patients. PLoS One 7:e29090. https://doi.org/10.1371/journal.pone.0029090

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Mortazavi SS, Shati M, Keshtkar A et al (2016) Defining polypharmacy in the elderly: a systematic review protocol. BMJ Open 6:e010989. https://doi.org/10.1136/bmjopen-2015-010989

    Article  PubMed  PubMed Central  Google Scholar 

  15. Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919

    Article  CAS  Google Scholar 

  16. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  CAS  Google Scholar 

  17. Mahoney FI, Barthel DW (1989) Functional evaluation: the barthel index. Md State Med J 14:61–65

    Google Scholar 

  18. Cucinotta D, Angelin A, Godoli G et al (1989) Proposta e validazione di un semplice indice per la valutazione funzionale globale dell’anziano: il GEFI. G Gerontol 38:31–36

    Google Scholar 

  19. Folstein M, Folstein SE, McHugh PR (1975) “Mini-Mental State” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  Google Scholar 

  20. Sheikh JI, Yesavage JA, Geriatric Depression Scale (GDS) (1986) Recent evidence and development of a shorter version. In: Brink TL (ed) Clinical gerontology: a guide to assessment and intervention. The Haworth Press, New York pp 165–173

    Google Scholar 

  21. Conwell Y, Forbes NT, Cox C et al (1993) Validation of a measure of physical illness burden at autopsy: the cumulative illness rating scale. J Am Geriatr Soc 41:38–41

    Article  CAS  Google Scholar 

  22. Amici A, Cicconetti P, Baratta A et al (2008) The Marigliano-Cacciafesta polypathology scale (MCPS): a tool for predicting the risk of developing disability. Arch Gerontol Geriatr 47:201–206

    Article  CAS  Google Scholar 

  23. Vellas B, Guigoz Y, Garry PJ (1996) Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 54:s59–s65

    PubMed  Google Scholar 

  24. Bliss MR, McLaren R, Exton Smith AN (1966) Mattresses for preventing pressure sores in geriatric patients. Monthly Bull Minist Health Publ Health Lab Serv 25:238–268

    CAS  Google Scholar 

  25. Pfeiffer E (1975) A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 23:433–441

    Article  CAS  Google Scholar 

  26. Haanes CG, Kirkevold M, Hofoss D et al (2015) Discrepancy between self-assessments and standardized tests of vision and hearing abilities in older people living at home: an ROC curve analysis. J Clin Nurs 24:3380–3388

    Article  Google Scholar 

  27. Viljanen A, Törmäkangas T, Vestergaard S et al (2014) Dual sensory loss and social participation in older Europeans. Eur J Ageing 11:155–167

    Article  Google Scholar 

  28. Eisele M, Kaduszkiewicz H, König H-H et al (2015) Determinants of health-related quality of life in older primary care patients: results of the longitudinal observational AgeCoDe study. Br J Gen Pract 65:e716–e723

    Article  Google Scholar 

  29. Gopinath B, Schneider J, McMahon CM et al (2013) Dual sensory impairment in older adults increases the risk of mortality: a population-based study. PLoS One 8:e55054

    Article  CAS  Google Scholar 

  30. Under Italian Law 104/92 (1992) Legge-quadro per l’assistenza, l’integrazione sociale e i diritti delle persone handicappate. Off Gaz Feb 17:39

    Google Scholar 

  31. Badley EM (1995) The genesis of handicap: definition, models of disablement, and role of external factors. Disabil Rehabil 17:53–62

    Article  CAS  Google Scholar 

  32. Rockwood K, Andrew M, Mitnitski A (2007) A comparison of two approacHES to measuring frailty in elderly people. J Gerontol Med Sci 62A:738–743

    Article  Google Scholar 

  33. Kulminski A, Yashin A, Arbeev K et al (2007) Cumulative index of health disorders as an indicator of the aging-associated processes in elderly: results from analyses of the national long term care survey. Mech Ageing Dev 128:250–258

    Article  CAS  Google Scholar 

  34. Mitnitski A, Mogilner AJ, MacKnight C et al (2002) The mortality rate as a function of accumulated deficits in a frailty index. Mech Ageing Dev 123:1457–1460.

    Article  Google Scholar 

  35. Yashin AI, Arbeev KG, Kulminski A et al (2007) Cumulative index of elderly disorders and its dynamic contribution to mortality and longevity. Rejuventation Res 10:75–86

    Article  Google Scholar 

  36. Millan-Calenti JC, Tubio J, Pita-Fernandez S et al (2010) Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr 50:306–310

    Article  Google Scholar 

  37. Feng L, Zin Nyunt MS, Gao Q et al (2016) Cognitive frailty and adverse health outcomes: findings from the singapore longitudinal ageing studies (SLAS). J Am Med Dir Assoc. https://doi.org/10.1016/j.jamda.2016.09.015

    Article  PubMed  Google Scholar 

  38. Robinson KL, McBeth J, Macfarlane GJ. (2004) Psychological distress and premature mortality in the general population: a prospective study. Ann Epidemiol 14:467–472

    Article  Google Scholar 

  39. Lam BL, Lee DJ, Gomez-Marin O et al (2006) Concurrent visual and hearing impairment and risk of mortality—the national health interview survey. Arch Ophthalmol 124:95–101

    Article  Google Scholar 

  40. Stringhini S, Berkman L, Dugravot A et al (2012) Socioeconomic status, structural and functional measures of social support, and mortality: the British Whitehall II Cohort Study, 1985–2009. Am J Epidemiol 175:1275–1283

    Article  Google Scholar 

  41. Pilotto A, Gallina P, Fontana A et al (2013) Development and validation of a multidimensional prognostic index for mortality based on a standardized multidimensional assessment schedule (MPI-SVaMA) in community-dwelling older subjects. J Am Med Dir Assoc 14:287–292

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Walter Verrusio, Giulia Spallacci, Maria Tecla Pecci, Maria Antonella Pappadà & Mauro Cacciafesta

  2. Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185, Roma, Italy

    Alessia Renzi

Authors
  1. Walter Verrusio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessia Renzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giulia Spallacci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maria Tecla Pecci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Antonella Pappadà
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mauro Cacciafesta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Walter Verrusio.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Statement of human and animal rights

All procedures performed in this study which involved human participants were in accordance with our institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Verrusio, W., Renzi, A., Spallacci, G. et al. The development of a new tool for the evaluation of handicap in elderly: the Geriatric Handicap Scale (GHS). Aging Clin Exp Res 30, 1187–1193 (2018). https://doi.org/10.1007/s40520-018-0907-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-018-0907-z

Keywords

Search

Navigation