The Timed Test of Money Counting: a simple method of recognizing geriatric patients at risk for increased health care.

The purpose of this prospective study was to measure patients' ability to open a purse, take out money, and count it, in order to identify persons in need of increased health care. The study population consisted of 183 patients (mean age 78.9; range: 66-95) in two settings: 78 consecutively admitted geriatric hospital patients who could return home, and 105 community-dwelling patients aged 70 years or older. None was completely dependent on others, nor severely demented. Time for task performance was measured. Further assessment included the Mini-mental State Examination (MMSE), Barthel index of ADL, instrumental activities of daily living (IADL), socioeconomic status, grip strength, Williams board test, and medication profile. The Timed Test of Money Counting (TTMC) was reliable (interrater and intrarater), and showed construct and concurrent validity with other measures of physical function. There was a strong correlation (p < 0.001) between the time required to count money, and to open and close the panel doors of the Williams board. The other functional measures were also significantly correlated with the TTMC. After 18 months, 26 of the patients had died, and 5 were lost to follow-up. The remainder were divided into those who had stable needs (group I), and those with increasing care needs or nursing home placement (group II). Time required for money counting was significantly different (p < 0.001) between groups (30.9 +/- 17.5 seconds for group I, and 122.6 +/- 94.4 seconds for group II).(ABSTRACT TRUNCATED AT 250 WORDS)