6533b828fe1ef96bd1287a94
RESEARCH PRODUCT
Comprehensive geriatric assessment in older people: an umbrella review of health outcomes
Nicola VeroneseCarlo CustoderoJacopo DemurtasLee SmithMario BarbagalloStefania MaggiAlberto CellaNicola VanacorePierangelo Lora AprileLuigi Ferrucci Pilotto Alberto Special Interest Group In Systematic Reviews Of The European Geriatric Medicine Society (Eugms): Pilotto AlbertoMaria Cristina PolidoriAlves MarianaBenzinger PetraBerg NicolasBrach JulieCardoso IrwinCella AlbertoChefi BenCiurea Annette Maria Cornejo Lingan Ana Santiago Cotobal RodelesCruz-jentoft AlfonsoCuriale VitoCustodero CarloDanielova LibuseDavies Franco Aafke De Groot Cathrine De Groot Jan De Lepeleire Benjamin De VriesDecock Anne-marieDenkinger MichaelDikmeer AyseDini SimoneDurand AmauryFatin AmiFernandes MariliaFerrara NicolaFrancis BahaaFratiglioni LauraFreiberger EllenGalvin RoseGarmendia BlancaGillain Sophie Javier Gomez PavonJ A GoudzwaardGreco AntonioGruner HeidiGunther BerndHappe LisaHermush Vered Jan-kees Huibregtse BimmelIndiano IlariaIsaak JuliaJaramillo JavierKerminen Hanna Ni Laocha AoifeLau SandraLozano Isabel Teresa Madeira Sarmento AnaMangoni Arduino Pedro Marques Da SilvaMars PatriciaMatejovska-kubesova Hana Francesco Mattace RasoMoeskops SimoneMolnar AndreaMusacchio ClarissaNagaratnam KirubaNieminen UomoO'connor Margaret Fatma ÖZge Kayhan KoçakPaccalin MarcPalikhe AnilPavic Tajana Raymond Per NordnesPlaton IzabelaPolinder HarmkePrada GabrielRagnheim RagnhildRamsawak LisaRewiuk KrzysztofRodrigues CarlosRoller-wirnsberger ReginaRossinen JuhaniRuotolo GiovanniRuppe GeorgRyan DanSabba CarloSanchez ElisabetSavas SumruSchmid VeronikaSchroderus KaisaSiegrist MonicaSmedberg DanielSmit OrlaSoulis GeorgeTampaki MariaTenkattelaar NatasiaThiem UlrichTopinkova EvaTromp Jorien Michiel Van Beek Lars Van HeijningenVandeelen BobVanderhulst HeleenVankova HanaVerissimo RafaelaVonk MerelVrabie CalinWearing PaulWeiss MichaelWelmer Anna-karinWerle BereniceYlmaz Ozlem Zaidi Shoaib MuhammadZamfir MihaelaZanom IloZuidhof JenNicola VeroneseLee SmithAlves MarianaAvcy SunaBahat-ozturk GulistanBalci CaferBeaudart CharlotteBruyère OlivierAntonio Cherubini Mariana Da Cruz AlvesFirth JosephGoisser SabineHursitoglu MehmetHurst ChristopherKemmler WolfgangKiesswetter EvaKotsani MarinaAi KoyanagiLocquet MédéaMarengoni AlessandraNida Mahwish Alexandru Obretin FlorianO'hanlon ShaneOkpe AndrewPedone ClaudioPetrovic MirkoPizzol DamianoProkopidis KonstantinosRempe Hanna Dolores Sanchez RodriguesSchoene DanielSchwingshackl LukasShenkin SusanSolmi MarcoSoysal PinarStubbs BrendonThompson TrevorTorbahn GabrielUnim Brigidsubject
Aged 80 and overAgingumbrella reviewFrailtyOutcome Assessmentcomprehensive geriatric assessment; older people; systematic review; umbrella review; Aged; Aged 80 and over; Humans; Independent Living; Outcome Assessment Health Care; Systematic Reviews as Topic; Frailty; Geriatric AssessmentGeneral Medicinecomprehensive geriatric assessmentcomprehensive geriatric assessment older people systematic review umbrella review Aged Aged 80 and over Humans Independent Living Outcome Assessment Health Care Systematic Reviews as Topic Frailty Geriatric Assessmentolder peopleHealth Caresystematic reviewOutcome Assessment Health Care80 and overHumansIndependent LivingGeriatrics and GerontologyGeriatric Assessmentcomprehensive geriatric assessment ; older people ; systematic review ; umbrella review.AgedSystematic Reviews as Topicdescription
Abstract Background Comprehensive geriatric assessment (CGA) has been in use for the last three decades. However, some doubts remain regarding its clinical use. Therefore, we aimed to capture the breadth of outcomes reported and assess the strength of evidence of the use of comprehensive geriatric assessment (CGA) for health outcomes in older persons. Methods Umbrella review of systematic reviews of the use of CGA in older adults searching in Pubmed, Embase, Scopus, Cochrane library and CINHAL until 05 November 2021. All possible health outcomes were eligible. Two independent reviewers extracted key data. The grading of evidence was carried out using the GRADE for intervention studies, whilst data regarding systematic reviews were reported as narrative findings. Results Among 1,683 papers, 31 systematic reviews (19 with meta-analysis) were considered, including 279,744 subjects. Overall, 13/53 outcomes were statistically significant (P < 0.05). There was high certainty of evidence that CGA reduces nursing home admission (risk ratio [RR] = 0.86; 95% confidence interval [CI]: 0.75–0.89), risk of falls (RR = 0.51; 95%CI: 0.29–0.89), and pressure sores (RR = 0.46; 95%CI: 0.24–0.89) in hospital medical setting; decreases the risk of delirium (OR = 0.71; 95%CI: 0.54–0.92) in hip fracture; decreases the risk of physical frailty in community-dwelling older adults (RR = 0.77; 95%CI: 0.64–0.93). Systematic reviews without meta-analysis indicate that CGA improves clinical outcomes in oncology, haematology, and in emergency department. Conclusions CGA seems to be beneficial in the hospital medical setting for multiple health outcomes, with a high certainty of evidence. The evidence of benefits is less strong for the use of CGA in other settings.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-05-01 |