PT - JOURNAL ARTICLE AU - R. Hebert TI - Functional decline in old age DP - 1997 Oct 15 TA - Canadian Medical Association Journal PG - 1037--1045 VI - 157 IP - 8 4099 - http://www.cmaj.ca/content/157/8/1037.short 4100 - http://www.cmaj.ca/content/157/8/1037.full SO - CMAJ1997 Oct 15; 157 AB - Functional decline is a common condition, occurring each year in nearly 12% of Canadians 75 years of age and older. The model of functional health proposed by the World Health Organization (WHO) represents a useful theoretical framework and is the basis for the SMAF (Systeme de measure de l'autonomie fonctionelle or Functional Autonomy Measurement System), an instrument that measures functional autonomy. The functional decline syndrome, in which functional autonomy is diminished or lost, may present as an acute condition, i.e., a medical emergency for which the patient must be admitted to a geriatric assessment unit. The subacute form is a more insidious condition in which the patient requires comprehensive assessment and a rehabilitation program. A preventive approach based on screening of those at risk and early intervention should prevent or delay the appearance of functional decline or diminish its consequences. Effective strategies for the prevention of or rehabilitation from functional decline will help reduce the incidence of disabilities and the period of dependence near the end of life. These strategies are absolute prerequisites for controlling sociohealth expenses and, most importantly, for allowing people to live independently in old age.