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Table 1 COPE assessment and criteria, and clinician assessment for the identification of impairments

From: Identifying common impairments in frail and dependent older people: validation of the COPE assessment for non-specialised health workers in low resource primary health care settings

Impairments

COPE

COPE criterion

Clinical examinationa

Nutrition

Mini nutritional assessment (MNA-SF®)

‘Malnourished’ (MNA score of <8)

Muscle bulk. Diet history. History of health conditions related to undernutrition. Current weight and history of weight loss. Oral and dental health.

Mobility

10 m walking test

Complete the walking test in > 15 s, and/or <7 chair stands in 30 s, or could not participate in the tasks because of severely restricted mobility.

Neurological examination, including power in major muscle groups. ADL difficulties.

Chair-stand test

EASY-Care checklist: Can you move yourself from bed to chair? Can you get around indoors? Can you manage stairs? Can you walk outside?

Vision

Snellen ‘tumbling E’ visual acuity chart

Visual acuity <6/18 in one or both eyes, or CHW impression of visual impairment for those not able to complete test

Counting fingers, hand motion, light perception.

EASY-Care checklist: Can you see (with glasses if worn?)

Hearing

Whisper voice test

Failed whisper voice test at 2 ft

Weber and Rinne tests. Vestibular function.

EASY-Care checklist: Can you hear (with hearing aid if worn)?

Continence

Single item from informant CSI-D ‘Does she have difficulty using the toilet? Does she wet of soil herself?’

Coded

EASY-Care checklist: Do you have accidents with your bladder? Do you have accidents with your bowels?

0. No problems

1. Occasionally wets bed

2. Frequently wets bed

3. Double incontinence

Cognition

Brief Community Screening Instrument for Dementia (CSI-D)

Combined score of <5

CNS Higher Functions; mental status examination; family history, medical history (underlying mental health conditions), addictions.

EASY-Care checklist: Do you have any concerns about memory loss or forgetfulness? Do you feel lonely? Have you suffered from any recent loss or bereavement?

In the past month…

Have you had any trouble sleeping? Have you had bodily pain? Have you often been bothered by feeling down, depressed or hopeless? Have you often been bothered by having little interest or pleasure in doing things?

Mood

Eight item Geriatric Depression Scale (GDS-8)

GDS score of > =3, or (for those not able to respond), informant report of depressed mood (NPI-Q q.4)

 

Behaviour

12 item Neuropsychiatric Inventory (NPI-Q)

One or more behavioural or psychological symptoms causing caregiver at least some distress

  1. aFor clinician assessment, the criterion was ‘clinical judgment’ in all cases