Risk groups and selective case finding in an elderly population

As the preventive approach gains ground in the care of the elderly there is increasing interest in screening or case-finding. Given the impracticability of visiting all those over a certain age, most GPs and health visitors concentrate on those considered to be at greatest risk of medical and social deterioration. This paper draws on data from a random sample of the elderly population of Aberdeen to examine the nature and extent of 'risk' experienced by those falling into a number of conventionally defined risk groups. It shows that few of these groups are comprehensively disadvantaged and most are inefficient for selective case-finding. An alternative approach based on answers to a carefully selected set of screening questions is shown to be more efficient, and suggestions are offered for further improvements.