Use of standardized brief geriatric evaluation compared with routine care in general practice for preventing functional decline: a pragmatic cluster-randomized trial

Abstract

The World Health Organization has defined healthy aging as the process of developing and maintaining functional ability that enables well-being in older age. 1 Functional ability is often measured by an individual's ability to perform activities of daily living (ADLs) without assistance. Geriatric syndromes, corresponding to multifactorial, chronic conditions, can impair physical and mental capacities, [2][3][4] and are directly associated with functional decline. 5 If recognized early, adapted preventive measures and management strategies can be started to limit functional decline. [6][7][8] Interventions that have been shown to delay functional decline include comprehensive geriatric assessment, regular home visits and physical therapy. 6,8,9 Comprehensive geriatric assessment consists of a "multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with ageing." 10 These assessments are usually performed by specialized geriatric teams for patients who have already been identified as frail or in the context of rehabilitation. However, most older patients see only their general practitioner (GP) and are not provided a comprehensive geriatric assessment, considering that this is a lengthy process that is often beyond the scope of a usual primary