Comprehensive Geriatric Assessment—Resolved and Unresolved Issues (Review)

Lapteva, E S; Ariev, A L; Tsutsunava, M R; Arieva, G T

doi:10.1134/s207905702104007x

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…In a realist review which assessed the use of CGA in improving health-related quality of life, findings showed that the use of CGA improved patient outcomes such as physical and cognitive function, reduced mortality and emergency hospitalisations [ 19 ], not only in older people in the hospital setting but also those in the community setting [ 25 , 26 ]. However, a recent review has shown that there are significant variations in the results from earlier CGA intervention studies [ 27 ], and the evidence for effectiveness is low.…”

Section: Discussionmentioning

confidence: 99%

A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty

et al. 2023

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Background Integrated care may improve outcomes for older people living with frailty. We aimed to assess the effectiveness of a new, anticipatory, multidisciplinary care service in improving the wellbeing and quality of life (QoL) of older people living with severe frailty. Methods A community-based non-randomised controlled study. Participants (≥65 years, electronic Frailty Index ≥0.36) received either the new integrated care service plus usual care, or usual care alone. Data collection was at three time points: baseline, 2-4 weeks, and 10-14 weeks. The primary outcome was patient wellbeing (symptoms and other concerns) at 2-4 weeks, measured using the Integrated Palliative care Outcome Scale (IPOS); the secondary outcome was QoL, measured using EQ-5D-5L. To test duration of effect and safety, wellbeing and QoL were also measured at 10-14 weeks. Descriptive statistics were used to characterise and compare intervention and control groups (eligible but had not accessed the new service), with t-test, Chi-Square, or Mann-Whitney U tests (as appropriate) to test differences at each time point. Generalised linear modelling, with propensity score matching, was used for further group comparisons. Data were analysed using STATA v17. Results 199 intervention and 54 control participants were recruited. At baseline, intervention and control groups were similar in age, gender, ethnicity, living status, and body mass index, but not functional status or area deprivation score. At 2-4 weeks, wellbeing had improved in the intervention group but worsened in the control (median IPOS -5 versus 2, p<0.001). QoL improved in the intervention group but was unchanged in the control (median EQ-5D-5L 0.12, versus 0.00, p<0.001). After adjusting for age, gender, and living status, the intervention group had an average total IPOS score reduction at 2-4 weeks of 6.34 (95% CI: -9.01: -4.26, p<0.05); this improvement was sustained, with an average total IPOS score reduction at 10-14 weeks of 6.36 (95% CI: -8.91:-3.80, p<0.05). After propensity score matching based on functional status/area deprivation, modelling showed similar results, with a reduction in IPOS score at 2-4 weeks in the intervention group of 7.88 (95% CI: -12.80: -2.96, p<0.001). Conclusions Our findings suggest that the new, anticipatory, multidisciplinary care service may have improved the overall wellbeing and quality of life of older people living with frailty at 2-4 weeks and the improvement in wellbeing was sustained at three months. Ethics approval NHS Research Ethics Committee 18/YH/0470 and IRAS-250981. Trial registration The trial was retrospectively registered at the International Standard Randomised Controlled Trial Number (ISRCTN) registry (registration date: 01/08/2022, registration number: ISRCTN10613839).

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Section: Discussionmentioning

confidence: 99%

A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty

et al. 2023

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Interrelation of Changes in the Left Ventricular Myocardium and Evidence of Clinical and Laboratory Indicators in Chronic Kidney Disease of Elderly

et al. 2022

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Geriatric Syndromes: The Importance of the Problem, Controversial Issues of Terminology

Лаптева,

Арьев,

Сафонова

et al. 2024

Успехи Геронтологии

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Основу здорового старения составляет профилактика инвалидности. В современном медицинском использовании гериатрический синдром относится к совокупности симптомов и признаков с единственной основной причиной, которая, может быть, пока неизвестна. Гериатрические синдромы же относятся к многофакторным состояниям здоровья и возникают, когда накопленные последствия нарушений в нескольких системах делают пожилого человека уязвимым к ситуационным изменениям. Использование термина «синдром» в гериатрии подчеркивает множественные причины единого проявления, включающие обилие факторов с вовлечением нескольких органов и систем, и характеризуется уникальными особенностями распространенных проблем со здоровьем у пожилых людей. Именно гериатрические синдромы могут оказывать существенное влияние на качество жизни и инвалидность. Поэтому в гериатрии необходимо раннее выявление данных медицинских состояний при использовании таргетной гериатрической оценки. Понимание сущности и феминологии гериатрических синдромов, правильное их позиционирование и интерпретация являются крайне актуальной проблемой. Основной целью представленного обзора как раз и является попытка ответить на эти вопросы. Кроме того, до настоящего времени не определено, нужно ли включать в диагноз гериатрические синдромы (исключение составляет лишь синдром саркопении, который в 2016 г. официально был включен в МКБ-10). The foundation of healthy aging is the prevention of disability. In modern medical usage, a syndrome refers to a collection of symptoms and signs with a single underlying cause that may not yet be known. Geriatric syndromes, on the other hand, refer to multifactorial health conditions and occur when the accumulated effects of impairments in multiple systems make an older person vulnerable to situational changes. The use of the term “syndrome” in geriatrics emphasizes the multiple causes of a single manifestation involving an abundance of factors involving multiple organs and systems and is characterized by unique features of common health problems in older adults. It is the geriatric syndromes that can have a significant impact on quality of life and disability. Therefore, early detection of these medical conditions using targeted geriatric assessment is essential in geriatrics. Understanding the essence and feminology of geriatric syndromes, their correct positioning and interpretation is an extremely urgent problem. The main purpose of the presented review is precisely to try to answer these questions. In addition, it has not yet been determined whether geriatric syndromes should be included in the diagnosis (the only exception is sarcopenia syndrome, which was officially included in the 10th International Classification of Diseases in 2016).

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Comprehensive Geriatric Assessment—Resolved and Unresolved Issues (Review)

Cited by 3 publications

References 35 publications

A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty

A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty

Interrelation of Changes in the Left Ventricular Myocardium and Evidence of Clinical and Laboratory Indicators in Chronic Kidney Disease of Elderly

Geriatric Syndromes: The Importance of the Problem, Controversial Issues of Terminology

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