How multidimensional assessments can assist those with complex needs

The essential feature of multidimensional assessment is that it is an

overall package of different assessments with the objective of reducing

disability and dependency and hence improving quality of life. However,

a drawback of studies of multidimensional assessment is that it is

difficult to attribute the benefits (if any) to a particular component of the

package, or to examine the benefit of specific components of the

package. Most studies have not provided sufficient data to examine

separately different types of assessment. The benefits of screening for

visual impairment in elderly people have recently been reviewed by

Smeeth and colleagues27

as part of a Cochrane effectiveness review.

There has been no randomised trial assessing the effectiveness of vision

screening alone in elderly people. Five multidimensional assessment

trials provided the reviewers with data on visual outcomes at least 6

months after the intervention.All the studies used self-reported vision problems which have low

sensitivity. None of the studies provided more detailed data on process,

such as the medical reasons for poor vision, referral recommendations,

uptake and barriers to uptake.