The primary objective of this prospective study is to develop a new method of classifying the prognosis of ambulatory patients according to their risk of long term mortality, institutionalization, morbidity (including the deterioration of pre-existing conditions or development of new problems) and functional deterioration.

Specifically, from a random sample of 2000 patients taken from a cohort of established patients followed for at least three years in a general medicine practice, the objectives are:

1. to identify the demographic, clinical, and functional status variable that predict the risk of death, morbid events (e.g., the development of new complications or deterioration of existing conditions), or the deterioration in functional status using a half of the cohort chosen at random;
2. to combine these findings into a prognostic scale that can be employed in routine clinical practice; and
3. to validate the performance of this scale in the second half of the cohort.

There are no interventions in this study. Patients already under medical care by Cornell physicians will be enrolled. The only requirements for patients are to complete the questionnaires on an annual basis.

Inclusion Criteria:

1. Patients who are currently under the care of Physicians at Cornell Internal Medicine Associates.

Exclusion Criteria:

1. Patients who do not wish to participate in the study.
2. Patients who are not able to provide informed written consent.