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fold of skin several centimeters proximal to the
knuckles near the middle of the hand, with the
long axis of the fold diagonal (45°) to the longitudinal axis of the hand to avoid naturalfoids of
skin. The caliper was allowed to remain closed for
exactly 60 sec and then removed, and the time for
the skin fold to retract back to the normal! skin
contour was measured in seconds. ‘The exact end
point was sometimes difficult to measure tn older
people; ifthe fold had not retracted completely in
and elasticity of the skin.
1. Skin looseness.* Preliminary investigation revealed that the skin fold at the junction of the chin
and neck was the most satisfactory for the measurement of skin looseness and also seemed to give
the best correlation with age. The measurement
was carried out by grasping the skin with the
thumb and forefinger, pulling it gently outward,
and applying the caliper opened to 4 cm so that
each leg wasfirmly against the skin lateral to the
fingers. The caliper was then allowed to close by
its own spring tension, and the height of the foid
of skin impinged was measured in mm on scale C.
The elongated ends of the legs impinge on a |-cm*
surface of skin and exert a pressure of 500 g. There
is little variation in spring tension in the fast 2. cm
closing range of the caliper. The heightof the fold
represented the degree of skin looseness. The presence of excess fat in the skin probably caused the
readings to err on the low side, but this was not
thought to result in serious error.
2. Skin retraction time.* The back of the hand was
found most suitable for measuring the elasticity of
the skin. The hand and forearm were placed at
rest on a table. The caliper was opened to 2 cm
(on the crossarm scale) and allowed to close ona
*The reliability of the skin looseness and skin retraction ume
measurements was tested by having two examiners take data on
20 hospital patents of various ages with the sian calipers. The
mean values with their standard deviations were: for skin looseaessinmm, 20.85 ~0 7! and 20 90 +0.70, for skin retraction
time an seconds, 58 27413 and 58.75 + 8.18. No segnificant
difference was found between the means ol the two examuners,
who had previously ascertained that their rechniques for using
the calipers were alike.
ness; and 4+, baldness complete to a “monk’s
cap” type.
Special Senses.
|. 4ccommoedation* was meas-
ured in diopters by use of the Prince refracting
rule. The average reading of the twoeyes was used.
2. Visual acuily* was measured by Snellen’stest.
It was found that use of the square root of the
average visual acuity (denominator) of the two
eyes made the scale more compressed and more
linear. Thus the best vision, 20/10, was represented as 3.2 (the square root of 10) and the worst,
20/200, as 14.1 (the square root of 200), and intermediate readings were similarly recorded.
3. Arcus senults was estimated on a 0 to 4+ scale.
Only slight limbic clouding was scored as 1 +, and
increasing clouding raised thescore.
4. Hearing* wastested in a tent in a quiet location with a rugged screening-type audiometer.**
“The tests were carried out under standardized conditions, but,
in view of the necessity of using an interpreter under field conditions, it was not feasible to repeat them with a different exam-
iner. The data are thought to be sutheiently reproducible to be of
relative value, although not so accurate perhaps as those obtained under more desirable conditions.
**The authors are grateful tv the Armed Services Medical Procureinent Agency, Fort Potten, N.Y , for loan uf the audiometer
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Co,
Figure 8. Skin calipers used in measuring looseness
3. The exposed skin of the hands andface was observed for the presenceofsenile changes such as keratoses, nevi, pigmentation, etc. The degree of such
change was estimated on a 0 to 4+ scale: the presence of only an occasional abnormality was scored
as | +, increasing abnormalities raised the score.
4. The degree of yreying ofthe Aatr was expressed
on a 0 to ++ scale as follows: 0, no greying; 1+,
slight “salt and pepper:” 2+, moderate “salt and
pepper,” 3+, nearly complete greying; and 4+,
complete greying.
5. The degree of baldness was expressed on a 0 to
4+ scale as follows: 0, no apparent balding; 1+,
sheht receding of the hair at the temples; 2+,
marked receding ofthe hair at the temples with
some thinning, 3+, marked thinning and bald-
oe ee
90 sec, this ime measurement was used.