Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 52, Issue 5 M264-M274, Copyright © 1997 by The Gerontological Society of America

JOURNAL ARTICLE

Methodology and feasibility of a home-based examination in disabled older women: the Women's Health and Aging Study

EM Simonsick, CE Maffeo, SK Rogers, EA Skinner, D Davis, JM Guralnik and LP Fried
Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Maryland, USA.

BACKGROUND: To ascertain disease and functional capacity in community- resident disabled older women in the Women's Health and Aging Study (WHAS), a prospective investigation of the causes and course of disability, a home-based standardized physical examination and performance test battery were developed. Thirty-nine tests were administered, 9 by a lay interviewer and 30 by a nurse. This scope and intensity of testing had not been performed previously in a home environment or on such a functionally limited population. Thus, substantial developmental work was required. This report describes the administrative procedures and field experience for each exam component, highlighting innovations pertinent to home administration. METHODS: Exclusion criteria, safety issues, administration time, completion rates, and reasons for incomplete data are reported. Administration time is based on 30 exams conducted over a 3-week period 90% of the way through baseline data collection. Completion status was determined using all 1,002 participants and is categorized as follows: complete; partial; not done, health; not done, other; and refused. RESULTS: Seventy-two percent of the screened, eligible respondents completed the 30-min interviewer-administered physical assessment and the 2-hr, 10- min nurse examination. Classifiable data were obtained for 90% of participants on 36 examination items. Lower completion rates were obtained on the other three tests primarily due to exclusions for health-related conditions; environmental constraints and participant refusal were minimal. CONCLUSION: Extensive, research-oriented physical evaluation can be successfully and safely performed in a home setting. In future studies, home-based examination may be preferable, as participation in the WHAS examination substantially exceeded rates for clinic-based exams in similar populations.

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