Development of a Comprehensive Approach for the Early Diagnosis of Geriatric Syndromes in General Practice

Abstract

According to demographic projections, a significant increase in the proportion of the elderly population is anticipated worldwide. This aging of the population will lead to an increase in the prevalence of chronic diseases and functional impairment. This expected increase will result in growing use of the health care system that societies are largely unprepared to address. General practitioners (GPs) are at the front line of this huge epidemiological challenge, but appropriate tools to diagnose and manage elderly patients in routine general practice are lacking. Indeed, while primary prevention and the management of common chronic diseases, such as hypertension, diabetes, or cardiac ischemic diseases, are routinely and mostly adequately performed in primary care, the management of geriatric syndromes is often incomplete. In order to address these shortcomings, this theoretical work aims to first develop, based on the best available evidence, a brief assessment tool (BAT) specifically designed for geriatric syndromes identification in general practice and, second, to propose a conceptual framework for the management of elderly patients in general practice that integrates the BAT instrument into the usual care of GPs. To avoid proposing unachievable goals for the care of elderly patients in general practice (for example, performing all the best screening tools for geriatric conditions identification and care), this work proposes an innovative way to combine geriatric assessment with the management of common chronic diseases.

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow

“…Conditions such as delirium, pressure ulcers, falls, and incontinence are GSs that have been described in the literature for many years, 5 , 6 but other conditions including functional and cognitive impairment, affective disorders, visual and hearing problems, self-neglect and elder abuse, malnutrition, eating and feeding problems, sleep problems, and even dizziness and syncope also have been included under the heading of GSs. 7 GSs can have a significant effect on patients’ quality of life, and, in some cases, there are interventions that can improve the patient’s prognosis. For example, falls occur in one-third of the older population (65 years and older) each year and have a significant effect on increased hospitalization rates, overall costs, disability, and even increased mortality.…”

Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017

“…The frequency of geriatric syndromes should be known according to age groups to enable the health care services to recognize the cases and refer patients to the necessary centers. 17 …”

Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Euroasian Association of Therapists

“…Эти семь вопросов позволяют выявить наиболее распространенные гериатрические синдромы: клинические проявления саркопении, когнитивные нарушения, расстройства настроения, недержание мочи, недостаточность питания, нарушение мобильности, снижение слуха и зрения [73]. Важно отметить, что в зависимости от клинической ситуации информация, необходимая для применения данной скрининговой шкалы, может быть получена как при сборе анамнеза (врач задает соответствующие вопросы по ходу беседы с пациентом в любом порядке), так и путем использования данного опросника как анкеты (врач задает вопросы подряд и фиксирует ответы).…”