im
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 naturalfolds of
skin, The caliper was allowed to remain closed for
exactly 60 sec and then removed, and the time for
the skin foid to retract back to the normal skin
contour was measured in seconds. The exact end
point was sometimes dificult to measure in older
people, if the fold had not retracted completelyin
90 sec, this time measurement was used.
3. The ex posed skin of the hands and face was observed for the presence ofsentle changes such as keratoses, nevl, pigmentation, etc. The degree of such
change was estimated on a 0 to ++ scale: the pres-
Figure 8. Skin calipers used in measuring looseness
and elasticity of the skin.
ence of only an occasional abnormality was scored
as 1+, increasing abnormalities raised the score.
+. The degree of greping ofthe hatr was expressed
ona OQ to4+-+ scale as follows: 0, no greving; 1+,
1. Skin looseness.* Preliminaryinvestigation revealed that the skin fold at the junction of the chin
slight “salt and pepper;” 2+, moderate “‘salt and
urement of skin looseness and also seemedto give
the best correlation with age. The measurement
5. The degree of baldness was expressed on a 0 to
++ scale as follows: 0, no apparent balding; 1+,
pepper; ’ 3+, nearly complete greying; and ++,
and neck was the most satisfactory for the meas-
complete greying.
was carried out by grasping the skin with the
slight receding of the hair at the temples; 2+,
and applying the caliper opened to + cm so that
each leg was firmly against the skin lateral to the
fingers. The caliper was then allowed to close by
some thinning; 3+, marked thinning and bald-
thumb and forefinger, pulling it gently outward,
marked receding of the hair at che temples with
ness; and 4+, baldness complete to a “monk's
of skin impinged was measured in mm on scale C.
cap” type.
Special Senses.
1. Accommedation* was measured in diopters by use of the Prince refracting
surface of skin and exert a pressure of 500 g. There
is little variation in spring tension in the last 2cm
closing range of the caliper. The height of the fold
average visual acuity (denominator) of the two
its own spring tension, and the height of the fold
The elongated ends of the legs impinge on a l-cm?
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
rule, The average reading of the two eyes wasused.
2. Visual acuity* was measured by Snellen’s test.
It was found that use of the square root of the
eyes made the scale more compressed and more
2. Skin retraction time.* The back of the hand was
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.
the skin. The hand and forearm were placed at
rest on a table. The caliper was opened to 2 cm
Only slight limbic clouding was scored as 1+, and
increasing clouding raised the score.
thought to result in serious error.
found most suitable for measuring theelasticity of
(on the crossarm scale) and allowed to close on a
Ue
*The reliability of the skin looseness and skin retraction time “8,
measurements was tested by having two examiners take data on
20 hospital patients of various ages with the skin calipers. The
mean values with their standard deviations were: for skin loosenessin mm, 20.850.71 and 20.90 20.70; for skin retraction
ume in seconds, 58.2+8.13 and 58.75+8.18 No significant
difference was found between the means of the two examiners,
who had previously ascertained that their techniques for using
the calipers were alike.
P'85551
3. Arcus senilis was estimated on a 0 to 4+ scale.
+. Hearing* was tested in a tent in a quiet loca-
tion 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 examiner. The data are thought to be sufficiently reproducible to be of
relative value, although not so accurate perhaps as those obtained under more desirable conditions.
“*The authors are grateful to the Armed Services Medical Pro-
curement Agency, Fort Totten, N Y., for Joan of the audiometer.