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Frailty and comprehensive geriatric assessment for older patients in the acute care setting: a systematic review and meta-analysis
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.ORCID iD: 0000-0002-3964-196X
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2015 (English)In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, no 6, 523-540 p., 6Article in journal (Refereed) Published
Abstract [en]

Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. 

Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. 

Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. 

Study eligibility: Randomized controlled trials. Participants: Older adults aged >= 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups. 

Intervention: CGA. 

Control: Usual care. 

Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. 

Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences. 

Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group. 

Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.

Place, publisher, year, edition, pages
2015. Vol. 6, no 6, 523-540 p., 6
Keyword [en]
Comprehensive geriatric assessment; Frailty; Acute care; Systematic review; Meta-analysis
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-19796DOI: 10.1016/j.eurger.2015.10.007ISI: 000368322100004Scopus ID: 000368322100004OAI: oai:DiVA.org:du-19796DiVA: diva2:862336
Available from: 2015-10-21 Created: 2015-10-21 Last updated: 2016-02-11Bibliographically approved

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CiteExportLink to record
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Citation style
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