A 10-min Targeted Geriatric Assessment Predicts Mortality in Fast-Paced Acute Care Settings: A Prospective Cohort Study

Aliberti, Márlon Juliano Romero; Covinsky, Kenneth E.; Apolinário, Daniel; Lee, S. J.; Fortes-Filho, Sileno Q.; Melo, Juliana A.; Viana, Simone Santana; Suemoto, Cláudia Kimie; Jacob‐Filho, Wilson

doi:10.1007/s12603-018-1152-z

Cited by 8 publications

(12 citation statements)

References 27 publications

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“…The 10-minute Targeted Geriatric Assessment (10-TaGA) [14] is a validated multidomain hands-on instrument that was developed to screen geriatric syndromes and estimate the global impairment of patients, using the cumulative de cit model. In previous research, 10-TaGA provided adequate validity and good accuracy in discriminating between frail and non-frail individuals and good predictive power for one-year mortality, disability and hospitalization [14,16,17]. This quick and easy-to-administer CGA-based tool assembles objective measures and selfreported information in an e cient method that evaluates ten health domains: (1) social support (living arrangements and availability of help) [18]; (2) emergency department visits and hospitalizations in the previous six months; (3) the number of falls in previous 12 months; (4) the number of medications; (5) dependence in activities of daily living (ADLs) (Katz index) [19]; (6) 10-point Cognitive Screener (10-CS) [20]; (7) self-rated health; (8) 4-item Geriatric Depression Scale (GDS-4) score [21]; (9) nutritional status (weight loss in the previous 12 months, BMI and calf circumference); (10) gait speed [14].…”

Section: Introductionmentioning

confidence: 89%

“…Each domain is categorized and scored as normal (0 points), mild impairment (0.5 points), or severe impairment (1 point), based on validated cut-off points against conventional and more extended instruments that are widely used in practice to assess each geriatric condition [14]. While 10-TaGA captures health de cits in multiple domains using rapid geriatric measures, which might be considered super cial, the tool proved to be a practical and e cient method to introduce the CGA in busy clinical settings where time-consuming instruments are unfeasible [14,16,17]. Based on previous work demonstrating the good predictive power of 10-TaGA for one-year mortality, we classi ed participants as having low (0-0.24), medium (0.25-0.49), or high (0.50-1) risk of death [17].…”

Section: Introductionmentioning

confidence: 99%

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Prospective GERiatric Observational (ProGERO) Study: cohort design and preliminary results

Saraiva

Rangel

Cunha

et al. 2020

Preprint

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Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of outpatient older adults in São Paulo, Brazil, to collect data both on aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of outpatient older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of aging, senescence, and senility, particularly in frail and pre-frail outpatients from an LMIC city.

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Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Prospective GERiatric Observational (ProGERO) Study: cohort design and preliminary results

Saraiva

Rangel

Cunha

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Finally, we screened for the presence of visual and auditive de cits ("yes" or "no") using the following questions, is calculated, dividing the total sum of points by the number of evaluated domains [14]. Based on previous work demonstrating the good predictive power of 10-TaGA for one-year mortality, we classi ed participants as having low (0-0.24), medium (0.25-0.49), or high (0.50-1) risk of death [17].…”

Section: Clinical Assessmentmentioning

confidence: 99%

“…Sample size calculations. Based on the 10-TaGA classi cation for mortality risk, we estimated our sample size using the log-rank test for comparisons of 12-month survival across three groups (low, medium, and high risk), with a proportion between groups of 1: 2: 1, respectively [17]. Assuming a one-year mortality rate of 2.5% in the lowest risk group [17], an alternative bilateral hypothesis, an alpha error of 0.05%, a beta error of 0.20 and an estimated sample loss of 15%, we projected that a total sample of 1,081 participants would be required to detect 5% differences between the groups.…”

Section: Analyses Planmentioning

confidence: 99%

Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

Saraiva

Rangel

Cunha

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of older adults in Brazil, to collect data both on healthy aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of community-dwelling older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of healthy and pathological aging in older adults from LMICs.

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“…Acrescentaríamos, ainda, um sexto e último M, de multidisciplinaridade, pois o cuidado desses idosos deve estar coordenado de forma horizontal por um profissional, mas nunca isolado em sua figura, sendo importante a participação de outros especialistas e profissionais de saúde. Na Unidade de Cardiogeriatria do InCor, para todos os pacientes é realizada uma avaliação geriátrica ampla com o auxílio da ferramenta TAGA-10 (Targeted Geriatric asssesment) 10,11 A Evolução da Cardiogeriatria…”

Section: A Essência Da Cardiogeriatriaunclassified

A Evolução do Cenário da Cardiogeriatria no Brasil: Novos Desafios para um Novo Mundo

Tavares

Cavalcanti

2020

ABC Cardiol

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A 10-min Targeted Geriatric Assessment Predicts Mortality in Fast-Paced Acute Care Settings: A Prospective Cohort Study

Cited by 8 publications

References 27 publications

Prospective GERiatric Observational (ProGERO) Study: cohort design and preliminary results

Prospective GERiatric Observational (ProGERO) Study: cohort design and preliminary results

Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

A Evolução do Cenário da Cardiogeriatria no Brasil: Novos Desafios para um Novo Mundo

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