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Evaluation

Are you evaluating an older community-dwelling adult?

Age of the patient

years

Gender of the patient

Body weight

Body height

Is the patient a current cigarette smoker?

Does the patient have?

• diabetes mellitus?

• cancer?

• lung disease?

• heart failure?

Is the patient impaired in the ability to?

• bathe self?

• manage own finances?

• walk several blocks?

• push or pull heavy objects?

Results

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