Gross intellectual impairment among non-institutionalized elderly: difficulties in assessment and risk factors.

Quality of life of both the aged person and his relatives depends, to a large extent, on the capacity of the old person to think and to remember. In an attempt to assess the intellectual capabilities (InC) of the elderly and to identify risk factors associated with intellectual impairment (InI), a community study was carried-out. The study population was ethnically heterogeneous and comprised of a high percentage of immigrants and of people who had never attended school. Some methodological issues related to studying InC of a population with these characteristics are discussed. A stratified random sample of non-institutionalized individuals aged 65+ years was home interviewed using a short, portable questionnaire which can be used by non-professional interviewers. The research tool is comprised of 10 questions which check time and place orientation as well as short and long term memory. Although the validity of the questionnaire needs further study, some conclusions can be drawn. Approximately 16% of the subjects failed to answer correctly at least 5 of the 10 questions. People over 75 years old, single persons, those with low education and low environmental stimulation were identified as high risk groups for InI, as defined in our study. Functional limitation, such as immobility, dependence in daily functions and hearing deprivation seem to affect the InC of the aged, especially of the less educated people. Such findings may suggest the need to plan community-oriented prevention programs for the sake of the growing population of the aged in western countries.