Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients

Luciano³

et al. 2020

Pilot Feasibility Stud

Background The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA). Methods/design We will enroll 40 adults with SCD (20 age 18–49.99 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, at 10 to 20 days after hospitalization, and at 12 months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events. Discussion We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.

Section: Discussionmentioning

confidence: 99%

Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study

Luciano³

et al. 2020

Pilot Feasibility Stud

“…For many individuals, longevity becomes less important if the quality of life is poor. Multiple studies have shown that interventions based on the GA improve not only survival for older adults in the general population, but improve patient-important outcomes such as mobility, endurance, and strength [76,77]. GA has been shown to preserve independence when implemented in hospitalized older adults [78].…”

Section: Discussionmentioning

confidence: 99%

Geriatric Assessment for Older Adults with Sickle Cell Disease: protocol for a prospective cohort pilot study

Luciano

et al. 2020

Preprint

Background The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA).Methods/Design Forty adults with SCD (20 age 18–49 years and 20 age ≥ 50 years) will be enrolled in a prospective cohort study to assess the feasibility of SCD-GA. We used a validated oncology geriatric assessment and enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, 10 to 20 days after hospitalization, and at after 12-months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events.Discussion We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.

“…For many individuals, longevity becomes less important if the quality of life is poor. Multiple studies have shown that interventions based on the geriatric assessment improve not only survival for older adults in the general population, but improve patient-important outcomes such as mobility, endurance, and strength [76,77]. Geriatric assessment has been shown to preserve independence when implemented in hospitalized older adults [78].…”

Section: Discussionmentioning

confidence: 99%

Geriatric Assessment for Older Adults with Sickle Cell Disease: protocol for a prospective cohort pilot study

Luciano

et al. 2020

Preprint

Background: The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA).Methods/Design: We will enroll 40 adults with SCD (20 age 18-49 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, 10 to 20 days after hospitalization, and at after 12-months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events.Discussion: We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.