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Outpatient comprehensive geriatric assessment: effects on frailty and mortality in old people with multimorbidity and high health care utilization
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS)Karolinska Institutet, Huddinge, Sweden; Geriatric Department of Danderyd Hospital, Stockholm, Sweden, Danderydsgeriatriken, Danderyd, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.ORCID iD: 0000-0001-7429-0889
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden; Institution of Clinical Research, Helsingborg Hospital, Lund University, Lund, Sweden.
2019 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 31, no 4, p. 519-525Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients.

AIMS: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization.

METHODS: The Ambulatory Geriatric Assessment-Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months. Frailty was a secondary outcome. Inclusion criteria were: age ≥ 75 years, ≥ 3 current diagnoses per ICD-10, and ≥ 3 inpatient admissions during 12 months prior to study inclusion. The intervention group received CGA-based care and tailored interventions by a multidisciplinary team in an Ambulatory Geriatric Unit, in addition to usual care. The control group received usual care. Frailty was measured with the Cardiovascular Health Study (CHS) criteria. At 24 months, frail and deceased participants were combined in the analysis.

RESULTS: Ninety percent of the population were frail or pre-frail at baseline. After 24 months, there was a significant smaller proportion of frail and deceased (p = 0.002) and a significant higher proportion of pre-frail patients in the intervention group (p = 0.004). Mortality was high, 18% in the intervention group and 26% in the control group.

CONCLUSION: Outpatient CGA may delay the progression of frailty and may contribute to the improvement of frail patients in older persons with multimorbidity.

Place, publisher, year, edition, pages
Milan, Italy: Springer - Verlag Italia Srl , 2019. Vol. 31, no 4, p. 519-525
Keywords [en]
Community dwelling, Comprehensive Geriatric Assessment, Frailty, Multimorbidity, Outpatient, Randomized controlled trial
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:liu:diva-150182DOI: 10.1007/s40520-018-1004-zPubMedID: 30039453Scopus ID: 2-s2.0-85050569790OAI: oai:DiVA.org:liu-150182DiVA, id: diva2:1239140
Available from: 2018-08-15 Created: 2018-08-15 Last updated: 2019-04-12Bibliographically approved

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Garvin, Peter

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