Mortality Risk and Its Association with Geriatric Domain Deficits in Older Outpatients: The Amsterdam Ageing Cohort

Abstract

<b><i>Introduction:</i></b> In older patients, life expectancy is determined by a complex interaction of multiple geriatric domains. A comprehensive geriatric assessment (CGA) captures different geriatric domains. Yet, if and how components of the CGA are related to mortality in an outpatient geriatric setting is unknown. In the Amsterdam Ageing Cohort, we therefore studied distribution and accumulation of geriatric domain deficits in relation to mortality. <b><i>Methods:</i></b> All patients received a CGA as part of standard care, independent of referral reason. We summarized deficits on the CGA, using predefined cutoffs, in 5 geriatric domains: somatic, mental, nutritional, physical, and social domain. Information on mortality was obtained from the Dutch municipal register. We used age- and sex-adjusted Cox proportional hazards analyses to relate the separate domains and accumulation of impaired domains to overall mortality. <b><i>Results:</i></b> From the 1,055 geriatric outpatients (53% female; age 79 ± 7 years), 172 patients (16%) had died after 1.7 ± 1.1 years. In 626 patients (59%), 3 or more domains were impaired. All domains were independently associated with mortality, with the highest hazard for the somatic domain (HR 3.7 [1.7–8.0]) and the lowest hazard for the mental domain (HR 1.5 [1.1–12.0]). In addition, accumulation of impaired domains showed a gradually increased mortality risk, ranging from HR 2.2 (0.8–6.1) for 2 domains to HR 9.6 (3.7–24.7) for all 5 domains impaired. <b><i>Conclusions:</i></b> This study provides evidence that impairment in multiple geriatric domains is highly prevalent and independently and cumulatively associated with mortality in an outpatient geriatric setting.

Assessing the Views of Professionals, Patients, and Care Partners Concerning the Use of Computer Tools in Memory Clinics: International Survey Study

“…A general link to the survey was sent via a newsletter and social media to the members (patients and care partners) of Alzheimer Europe and directly to the members of the Alzheimer’s Society United Kingdom. Next, we invited both patients and care partners from the Amsterdam Dementia Cohort of the Alzheimer Center Amsterdam [ 36 , 37 ] and the Amsterdam Aging Cohort of the outpatient geriatric clinic of the Amsterdam University Medical Center (Amsterdam University Medical Centers) [ 38 ]. Patients and care partners were approached and informed by phone or email, and when they confirmed their participation, they were sent a personalized link to the web-based survey.…”

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

“…The Amsterdam Aging Cohort is an ongoing longitudinal cohort study which includes patients from the outpatient geriatric clinic at the Amsterdam University Medical Center, location VUmc (Rhodius-Meester et al, 2021 ). We included 893 patients with brain imaging who attended the memory clinic seeking medical care between February 2016 and June 2021.…”

An Interprofessional Student‐Run Medication Review Program: The Clinical STOPP/START‐Based Outcomes of a Controlled Clinical Trial in a Geriatric Outpatient Clinic

“…This controlled clinical trial was performed at a geriatric memory outpatient clinic in a tertiary academic hospital. The memory outpatient clinic is for patients aged 70 years who are suspected to have cognitive function decline 26 . Patients are referred by their GP, a medical specialist, or as second opinion from another hospital.…”

“…The memory outpatient clinic is for patients aged 70 years who are suspected to have cognitive function decline. 26 Patients are referred by their GP, a medical specialist, or as second opinion from another hospital. During 1 day at the memory outpatient clinic, 4 patients can be planned for an outpatient clinic visit.…”