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Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive
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Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 84176

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Dr. G. Darryl Wieland

E-Mail Website
Guest Editor
1. Geriatric Research, Education and Clinical Center [GRECC], Durham VA Medical Center, NC, USA
2. Center for Population Health and Aging, Duke University, Durham, NC, USA
Interests: comprehensive geriatric assessment; population health management; geriatric case-mix and risk modeling; models of geriatric care; long-term care; geriatric workforce development

Special Issue Information

Dear Colleagues,

Geriatric assessment—broadly defined—is the foundation of care for frail elderly people at risk for functional decline, death, and long-term institutionalization. Its key feature is ascertainment of multiple dimensions of health and health risks—not only medical, but functional, cognitive, psychological, and socioeconomic status. This multidimensionality is key to systematic screening and targeting to uncover frail, at-risk elderly people in their neighborhoods, homes, and at various other service contact points, for more intensive evaluation, i.e., “comprehensive geriatric assessment” (CGA)—a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional limitations of a frail older person to develop a coordinated plan to maximize overall health with aging.

CGA imbedded in different geriatric care models—in the community and in institutions—has been studied for years, with evidence supporting the efficacy of some models in improving outcomes. In fact, early successes are partly responsible for the spread and differentiation of CGA-based programs, involving teams of specially trained health professions, together with the continued growth in numbers of frail and at-risk elderly in demographically post-transition populations. CGA also supports various “co-care” or collaborative approaches with orthopedics, oncology, surgery, and other disciplines. Developing countries—also rapidly aging and improving their services resources—have an emerging interest in geriatric medicine and care systems, including adaptation of practice and CGA technologies.

We invite international submissions describing new or established CGA-oriented or based processes, technologies and models of care, particularly welcoming evaluations, quasi-experiments, and randomized trials aimed at establishing their outcomes, costs, and value.

Dr. G. Darryl Wieland
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Comprehensive geriatric assessment
  • Geriatric screening/targeting
  • Geriatric multi- and interdisciplinary team care
  • Geriatric care models
  • Geriatric collaborative care
  • Frailty
  • Geriatric syndromes
  • Geriatric care outcomes

Published Papers (13 papers)

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Editorial

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3 pages, 153 KiB  
Editorial
New Variations on the Theme of Multidimensional Geriatric Assessment
by G. Darryl Wieland
Geriatrics 2020, 5(4), 104; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics5040104 - 17 Dec 2020
Viewed by 1614
Abstract
Geriatric assessment—broadly defined—has become foundational to systems of care for frail elderly people at risk for functional decline, death, intensification of services, and long-term institutionalization [...] Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)

Research

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6 pages, 183 KiB  
Article
The Convergent Validity of the electronic Frailty Index (eFI) with the Clinical Frailty Scale (CFS)
by Antoinette Broad, Ben Carter, Sara Mckelvie and Jonathan Hewitt
Geriatrics 2020, 5(4), 88; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics5040088 - 09 Nov 2020
Cited by 15 | Viewed by 4791
Abstract
Background: Different scales are being used to measure frailty. This study examined the convergent validity of the electronic Frailty Index (eFI) with the Clinical Frailty Scale (CFS). Method: The cross-sectional study recruited patients from three regional community nursing teams in the South East [...] Read more.
Background: Different scales are being used to measure frailty. This study examined the convergent validity of the electronic Frailty Index (eFI) with the Clinical Frailty Scale (CFS). Method: The cross-sectional study recruited patients from three regional community nursing teams in the South East of England. The CFS was rated at recruitment, and the eFI was extracted from electronic health records (EHRs). A McNemar test of paired data was used to compare discordant pairs between the eFI and the CFS, and an exact McNemar Odds Ratio (OR) was calculated. Findings: Of 265 eligible patients consented, 150 (57%) were female, with a mean age of 85.6 years (SD = 7.8), and 78% were 80 years and older. Using the CFS, 68% were estimated to be moderate to severely frail, compared to 91% using the eFI. The eFI recorded a greater degree of frailty than the CFS (OR = 5.43, 95%CI 3.05 to 10.40; p < 0.001). This increased to 7.8 times more likely in men, and 9.5 times in those aged over 80 years. Conclusions: This study found that the eFI overestimates the frailty status of community dwelling older people. Overestimating frailty may impact on the demand of resources required for further management and treatment of those identified as being frail. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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12 pages, 808 KiB  
Article
Evaluation of a Combined HIV and Geriatrics Clinic for Older People Living with HIV: The Silver Clinic in Brighton, UK
by Tom Levett, Katie Alford, Jonathan Roberts, Zoe Adler, Juliet Wright and Jaime H. Vera
Geriatrics 2020, 5(4), 81; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics5040081 - 19 Oct 2020
Cited by 18 | Viewed by 3208
Abstract
As life expectancy in people living with HIV (PLWH) has increased, the focus of management has shifted to preventing and treating chronic illnesses, but few services exist for the assessment and management of these individuals. Here, we provide an initial description of a [...] Read more.
As life expectancy in people living with HIV (PLWH) has increased, the focus of management has shifted to preventing and treating chronic illnesses, but few services exist for the assessment and management of these individuals. Here, we provide an initial description of a geriatric service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen in the clinic between 2016 and 2019. We present patient demographic data, assessment outcomes, diagnoses given, and interventions delivered to those seen in the clinic. The average age of attendees was 67. Primary reasons for referral to the clinic included management of complex comorbidities, polypharmacy, and suspected geriatric syndrome (falls, frailty, poor mobility, or cognitive decline). The median (range) number of comorbidities and comedications (non-antiretrovirals) was 7 (2–19) and 9 (1–15), respectively. All attendees had an undetectable viral load. Geriatric syndromes were observed in 26 (50%) patients reviewed in the clinic, with frailty and mental health disease being the most common syndromes. Interventions offered to patients included combination antiretroviral therapy modification, further health investigations, signposting to rehabilitation or social care services, and in-clinic advice. High levels of acceptability among patients and healthcare professionals were reported. The evaluation suggests that specialist geriatric HIV services might play a role in the management of older people with HIV with geriatric syndromes. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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6 pages, 1242 KiB  
Communication
The Clinical Frailty Scale: Do Staff Agree?
by Rebekah L. Young and David G. Smithard
Geriatrics 2020, 5(2), 40; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics5020040 - 25 Jun 2020
Cited by 13 | Viewed by 6945
Abstract
The term frailty is being increasingly used by clinicians, however there is no strict consensus on the best screening method. The expectation in England is that all older patients should have the Clinical Frailty Scale (CFS) completed on admission. This will frequently rely [...] Read more.
The term frailty is being increasingly used by clinicians, however there is no strict consensus on the best screening method. The expectation in England is that all older patients should have the Clinical Frailty Scale (CFS) completed on admission. This will frequently rely on junior medical staff and nurses, raising the question as to whether there is consistency. We asked 124 members of a multidisciplinary team (consultants, junior doctors, nurses, and allied health professionals; physiotherapists, occupational therapists, dietitians, speech and language therapists) to complete the CFS for seven case scenarios. The majority of the participants, 91/124 (72%), were trainee medical staff, 16 were senior medical staff, 12 were allied health professions, and 6 were nurses. There was broad agreement both between the professions and within the professions, with median CFS scores varying by a maximum of only one point, except in case scenario G, where there was a two-point difference between the most junior trainees (FY1) and the nursing staff. No difference (using the Mann–Whitney U test) was found between the different staff groups, with the median scores and range of scores being similar. This study has confirmed there is agreement between different staff members when calculating the CFS with no specific preceding training. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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9 pages, 1192 KiB  
Article
Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults
by Gwendolen Buhr, Carrissa Dixon, Jan Dillard, Elissa Nickolopoulos, Lynn Bowlby, Holly Canupp, Loretta Matters, Thomas Konrad, Laura Previll, Mitchell Heflin and Eleanor McConnell
Geriatrics 2019, 4(4), 59; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4040059 - 21 Oct 2019
Cited by 7 | Viewed by 6490
Abstract
Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cognitive impairment. As the US population [...] Read more.
Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cognitive impairment. As the US population ages, discovering strategies to address these complex care needs within primary care are urgently needed. This article describes the development of an innovative, team-based model to improve the diagnosis and care of older adults with cognitive impairment in primary care practices. This model was developed through a mentoring process from a team with expertise in geriatrics and quality improvement. Refinement of the existing assessment process performed during routine care allowed patients with cognitive impairment to be identified. The practice team then used a collaborative workflow to connect patients with appropriate community resources. Utilization of these processes led to reduced referrals to the geriatrics specialty clinic, fewer patients presenting in a crisis to the social worker, and greater collaboration and self-efficacy for care of those with cognitive impairment within the practice. Although the model was initially developed to address cognitive impairment, the impact has been applied more broadly to improve the care of older adults with multimorbidity. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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10 pages, 219 KiB  
Article
The Relationship of Balance Disorders with Falling, the Effect of Health Problems, and Social Life on Postural Balance in the Elderly Living in a District in Turkey
by Tahsin Barış Değer, Zeliha Fulden Saraç, Emine Sumru Savaş and Selahattin Fehmi Akçiçek
Geriatrics 2019, 4(2), 37; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4020037 - 17 May 2019
Cited by 14 | Viewed by 7429
Abstract
The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 [...] Read more.
The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 community-dwelling elderly individuals with a mean age of 73.99 ± 6.6 years were enrolled after being selected by stratified random sampling. The study was performed as a face-to-face survey in the homes of elderly individuals. Sociodemographic and medical data were obtained from elderly individuals using the Elderly Identification Form. Balance disorders were determined using the Berg Balance Scale (BBS). In this study, the prevalence of balance disorders was found to be 34.3% in the community-dwelling elderly. Older age, physical disability, having four or more chronic illnesses, the presence of incontinence, having a history of falls, not walking regularly, absence of free time activity, and obesity were found to be associated with an increased prevalence of balance disorders. Balance disorders are commonly seen in the elderly and may be triggered by a variety of biological and social factors. It is crucial to develop and implement national health and social policies to eliminate the causes of this problem, as well as to prioritize preventive health services in the ever-increasing elderly population.
Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
9 pages, 216 KiB  
Article
Comprehensive Geriatric Assessment and Nutrition-Related Assessment: A Cross-Sectional Survey for Health Professionals
by Junko Ueshima, Keisuke Maeda, Hidetaka Wakabayashi, Shinta Nishioka, Saori Nakahara and Yoji Kokura
Geriatrics 2019, 4(1), 23; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4010023 - 15 Feb 2019
Cited by 3 | Viewed by 7168
Abstract
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related [...] Read more.
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related assessments. (2) Methods: We conducted a questionnaire survey on clinical use of CGA, assessment of sarcopenia/sarcopenic dysphagia/cachexia, and defining nutritional goals/the Nutrition Care Process/the International Classification of Functioning, Disability, and Health (ICF)/the Kuchi–Kara Taberu Index. (3) Results: The number of respondents was 652 (response rate, 12.0%), including 77 who used the CGA in the general practice. The univariate analyses revealed that participants using the CGA tended to assess sarcopenia (P = 0.029), sarcopenic dysphagia (P = 0.001), and define nutritional goals (P < 0.001). Multivariate logistic regression analyses for the CGA usage revealed that using ICF (P < 0.001), assessing sarcopenia (P = 0.001), sarcopenic dysphagia (P = 0.022), and cachexia (P = 0.039), and defining nutritional goals (P = 0.001) were statistically significant after adjusting for confounders. (4) Conclusions: There are correlations between the use of CGA and evaluation of sarcopenia, sarcopenic dysphagia, and cachexia and nutritional goals. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
8 pages, 194 KiB  
Article
Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program
by Lucy Morse, Linda Xiong, Vanessa Ramirez-Zohfeld, Scott Dresden and Lee A. Lindquist
Geriatrics 2019, 4(1), 18; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4010018 - 29 Jan 2019
Cited by 11 | Viewed by 8227
Abstract
The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults [...] Read more.
The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
12 pages, 532 KiB  
Article
Feeling Respected as a Person: a Qualitative Analysis of Frail Older People’s Experiences on an Acute Geriatric Ward Practicing a Comprehensive Geriatric Assessment
by Theresa Westgård, Katarina Wilhelmson, Synneve Dahlin-Ivanoff and Isabelle Ottenvall Hammar
Geriatrics 2019, 4(1), 16; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4010016 - 25 Jan 2019
Cited by 9 | Viewed by 7844
Abstract
Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary [...] Read more.
Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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13 pages, 247 KiB  
Article
Point of Care Quantitative Assessment of Muscle Health in Older Individuals: An Investigation of Quantitative Muscle Ultrasound and Electrical Impedance Myography Techniques
by Lisa D Hobson-Webb, Paul J Zwelling, Ashley N Pifer, Carrie M Killelea, Mallory S Faherty, Timothy C Sell and Amy M Pastva
Geriatrics 2018, 3(4), 92; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics3040092 - 16 Dec 2018
Cited by 14 | Viewed by 5608
Abstract
Background: Muscle health is recognized for its critical role in the functionality and well-being of older adults. Readily accessible, reliable, and inexpensive methods of measuring muscle health are needed to advance research and clinical care. Methods: In this prospective, blinded study, 27 patients [...] Read more.
Background: Muscle health is recognized for its critical role in the functionality and well-being of older adults. Readily accessible, reliable, and inexpensive methods of measuring muscle health are needed to advance research and clinical care. Methods: In this prospective, blinded study, 27 patients underwent quantitative muscle ultrasound (QMUS), standard electrical impedance myography (sEIM), and handheld electrical impedance myography (hEIM) of the anterior thigh musculature by two independent examiners. Subjects also had dual-energy X-ray absorptiometry (DEXA) scans and standardized tests of physical function and strength. Data were analyzed for intra- and inter-rater reliability, along with correlations with DEXA and physical measures. Results: Measures of intra- and inter-rater reliability were excellent (>0.90) for all QMUS, sEIM, and hEIM parameters except intra-rater reliability of rectus femoris echointensity (0.87–0.89). There were moderate, inverse correlations between QMUS, sEIM, and hEIM parameters and measures of knee extensor strength. Moderate to strong correlations (0.57–0.81) were noted between investigational measures and DEXA-measured fat mass. Conclusions: QMUS, sEIM and hEIM were highly reliable in a controlled, same-day testing protocol. Multiple correlations with measures of strength and body composition were noted for each method. Point-of-care technologies may provide an alternative means of measuring health. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)

Review

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9 pages, 201 KiB  
Review
Geriatric Assessment in Multicultural Immigrant Populations
by Katherine T. Ward, Mailee Hess and Shirley Wu
Geriatrics 2019, 4(3), 40; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4030040 - 26 Jun 2019
Cited by 5 | Viewed by 7805
Abstract
While the traditional comprehensive geriatric assessment provides valuable information essential to caring for older adults, it often falls short in multicultural immigrant populations. The number of foreign-born older adults is growing, and in some regions of the United States of America (U.S.), they [...] Read more.
While the traditional comprehensive geriatric assessment provides valuable information essential to caring for older adults, it often falls short in multicultural immigrant populations. The number of foreign-born older adults is growing, and in some regions of the United States of America (U.S.), they encompass a significant portion of the older adult population. To ensure we are caring for this culturally diverse population adequately, we need to develop a more culturally competent comprehensive geriatric assessment. In this review, we explore ways in which to do this, address areas unique to multicultural immigrant populations, and identify limitations of the current assessment tools when applied to these populations. In order to be more culturally sensitive, we should incorporate the concepts of ethnogeriatrics into a comprehensive geriatric assessment, by addressing topics like healthcare disparities, language barriers, health literacy, acculturation level, and culturally defined beliefs. Additionally, we must be sensitive to the limitations of our current assessment tools and consider how we can expand our assessment toolkit to address these limitations. We discuss the limitations in cognitive screening tests, delirium assessments, functional and mental health assessments, advance care planning, and elder abuse. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
13 pages, 746 KiB  
Review
Comprehensive Geriatric Assessment as a Versatile Tool to Enhance the Care of the Older Person Diagnosed with Cancer
by Janine Overcash, Nikki Ford, Elizabeth Kress, Caitlin Ubbing and Nicole Williams
Geriatrics 2019, 4(2), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics4020039 - 24 Jun 2019
Cited by 29 | Viewed by 8802
Abstract
The comprehensive geriatric assessment (CGA) is a versatile tool for the care of the older person diagnosed with cancer. The purpose of this article is to detail how a CGA can be tailored to Ambulatory Geriatric Oncology Programs (AGOPs) in academic cancer centers [...] Read more.
The comprehensive geriatric assessment (CGA) is a versatile tool for the care of the older person diagnosed with cancer. The purpose of this article is to detail how a CGA can be tailored to Ambulatory Geriatric Oncology Programs (AGOPs) in academic cancer centers and to community oncology practices with varying levels of resources. The Society for International Oncology in Geriatrics (SIOG) recommends CGA as a foundation for treatment planning and decision-making for the older person receiving care for a malignancy. A CGA is often administered by a multidisciplinary team (MDT) composed of professionals who provide geriatric-focused cancer care. CGA can be used as a one-time consult for surgery, chemotherapy, or radiation therapy providers to predict treatment tolerance or as an ongoing part of patient care to manage malignant and non-malignant issues. Administrative support and proactive infrastructure planning to address scheduling, referrals, and provider communication are critical to the effectiveness of the CGA. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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Other

18 pages, 1017 KiB  
Protocol
Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study
by Katarina Wilhelmson, Isabelle Andersson Hammar, Anna Ehrenberg, Johan Niklasson, Jeanette Eckerblad, Niklas Ekerstad, Theresa Westgård, Eva Holmgren, N. David Åberg and Synneve Dahlin Ivanoff
Geriatrics 2020, 5(1), 5; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics5010005 - 24 Jan 2020
Cited by 9 | Viewed by 6737
Abstract
The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome [...] Read more.
The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care. Full article
(This article belongs to the Special Issue Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive)
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