RT Book, Section A1 Hardy, Susan E. A2 Williams, Brie A. A2 Chang, Anna A2 Ahalt, Cyrus A2 Chen, Helen A2 Conant, Rebecca A2 Landefeld, C. Seth A2 Ritchie, Christine A2 Yukawa, Michi SR Print(0) ID 1100065188 T1 Consideration of Function & Functional Decline T2 Current Diagnosis & Treatment: Geriatrics, 2e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-179208-0 LK accessmedicine.mhmedical.com/content.aspx?aid=1100065188 RD 2024/04/18 AB Maintenance of function is a main goal of geriatric care and is an important element of successful aging. Like other geriatric syndromes, functional decline is multifactorial; medical, psychological, social, and environmental factors can all contribute to impaired functional status. The revised World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a framework for the evaluation of function and the prevention and treatment of functional decline that emphasizes the interrelation of contributing factors. The ICF classifies abnormalities in organ system structure or physiologic function as impairments. These impairments lead to difficulties with individual activities, and the limitations and barriers associated with those difficulties lead, in turn, to reduced participation in society. Environmental factors (eg, ramps and grab-bars) and personal factors (eg, education or social support) that do nothing to address underlying impairment can nonetheless influence the effect of impairments on activities and social participation. For example, a woman with severe benign essential tremor (impairment) may have difficulty eating (activity) and therefore not go out to lunch with friends (participation). Interventions to improve function in older adults can address not only the underlying impairments, but also the relevant personal and environmental factors.