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Journal of Aging Research
Volume 2015 (2015), Article ID 256414, 7 pages
http://dx.doi.org/10.1155/2015/256414
Research Article

Which Part of a Short, Global Risk Assessment, the Risk Instrument for Screening in the Community, Predicts Adverse Healthcare Outcomes?

1Centre for Gerontology and Rehabilitation, University College Cork, St. Finbarr’s Hospital, Douglas Road, Cork, Ireland
2COLLAGE (Collaboration on Ageing), University College Cork, Cork City and Louth Age Friendly County Initiative, County Louth, Ireland
3UZIK Consulting Inc., 86 Gerrard Street E, Unit 12D, Toronto, ON, Canada M5B 2J1
4Centre for Public Health Nursing, Ballincollig and Bishopstown, County Cork, Ireland
5Centre for Public Health Nursing, Mahon and Ballintemple, Cork, Ireland
6Health Service Executive, South Lee, St. Finbarr’s Hospital, Cork, Ireland
7School of Nursing & Midwifery, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Ireland
8Primary Healthcare University Research Institute, IDIAP Jordi Gol, Barcelona, Spain
9UNIFAI/ICBAS, Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
10School of Medicine and Pharmacology, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia

Received 12 December 2014; Accepted 13 March 2015

Academic Editor: F. R. Ferraro

Copyright © 2015 Rónán O’Caoimh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (concern, its severity, and the ability of the caregiver network to manage concern) make to the accuracy of the instrument, across its three domains (mental state, activities of daily living (ADL), and medical state), by comparing their accuracy to other assessment instruments in the prospective Community Assessment of Risk and Treatment Strategies study. RISC scores were available for 782 patients. Across all three domains each subtest more accurately predicted institutionalisation compared to hospitalisation or death. The caregiver network’s ability to manage ADL more accurately predicted institutionalisation (AUC 0.68) compared to hospitalisation (AUC 0.57, ) or death (AUC 0.59, ), comparing favourably with the Barthel Index (AUC 0.67). The severity of ADL (AUC 0.63), medical state (AUC 0.62), Clinical Frailty Scale (AUC 0.67), and Charlson Comorbidity Index (AUC 0.66) scores had similar accuracy in predicting mortality. Risk of hospitalisation was difficult to predict. Thus, each component, and particularly the caregiver network, had reasonable accuracy in predicting institutionalisation. No subtest or assessment instrument accurately predicted risk of hospitalisation.