The Correct Answer is C
Statement C is NOT true: Low functional status IS strongly associated with increased morbidity and mortality in geriatric patients, making this the false statement. 1
Analysis of Each Statement
Statement A - TRUE
Approximately 50% of the oldest-old (aged 85+) requiring assistance with daily activities is accurate. The evidence confirms that functional decline increases with advancing age, and the oldest-old population has substantial care needs 1. Research specifically examining patients 85 and older demonstrates that roughly half have poor premorbid functional status, defined as dependence in activities of daily living 2.
Statement B - TRUE
The activities mentioned correctly encompass both:
- Basic activities of daily living (ADLs): dressing, eating, ambulating/transferring, toileting, and bathing
- Instrumental activities of daily living (IADLs): shopping, meal preparation, household cleaning, medication management, finance management, communication via technology, and transportation arrangement 1
Statement C - FALSE (The Answer)
This statement is demonstrably incorrect. The evidence clearly establishes that:
- Poor functional status doubles the odds of death within one year in patients 85 and older (adjusted OR 2.15; 95% CI 1.68-2.76) 2
- Observational studies consistently show that multimorbidity and functional decline lead to higher mortality, increased hospitalization, and greater healthcare costs 1
- Lower functional capacity correlates with worse health outcomes across geriatric populations 3
Statement D - TRUE
Depression can exacerbate functional decline. The guideline notes that older adults experience physical, cognitive, and/or functional decline, and depression is recognized as a factor affecting functional status in the context of multicomplexity 1.
Statement E - TRUE
Impaired vision and hearing loss are recognized contributors to functional decline. These sensory impairments affect the ability to perform both basic and instrumental activities of daily living, particularly in the context of the multicomplexity framework for geriatric assessment 1.
Clinical Significance
The strong association between functional status and mortality/morbidity is why clinicians should periodically assess both basic and instrumental activities of daily living in older adults 1. This assessment becomes critical for prognosis discussions and care planning, particularly as goals shift toward maintaining functional status and symptom management in advanced age 1.