COMPrehensive geriatric AsseSSment and multidisciplinary team intervention for hospitalised older adults (COMPASS): a protocol of pragmatic trials within a cohort

Choi, Jung Yeon; Lee, Ji Yeon; Shin, Jaeyong; Kim, Chang Oh; Kim, Kwang Joon; Hwang, In Gyu; Lee, Yun‐Gyoo; Koh, Su‐Jin; Hong, Soojung; Yoon, Sol-Ji; Kang, Min-gu; Kim, Jin Won; Kim, Jee Hyun; Kim, Kwang Il

doi:10.1136/bmjopen-2022-060913

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…According to the WHO, treatment for the elderly impacts more than 80% of healthcare costs [ 1, 12 ]. Therefore, a widespread network of professionals is essential to respond to these people’s needs [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Then, our results suggest that supra-aortic trunk echo-Doppler should be included in the geriatric evaluation to allow the identification of cardiovascular alterations and the stratification of cardio-cerebrovascular risk. Moreover, patients with cardiovascular risk factors should undergo neuropsychological evaluation to allow adequate stratification of cardiovascular risk and cognitive decline [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Early Detection Screening of Cognitive Decline in Patients Over 60 Years: ELDERCARE Study

Putignano,

Forgione,

Fusco

et al. 2024

JAD

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Background: Dementia is the fourth leading cause of death in people > 65 years old in western countries. Objective: This cross-sectional assisted survey aimed to evaluate a multidisciplinary team approach of specialists of the Associazione Geriatri Extraospedalieri a favore di Anziani Svantaggiati and pharmacists to facilitate progress in the early identification and management of cognitive decline in patients > 60 years. Methods: A multidisciplinary team conducted this cross-sectional assisted survey. Patients (>60 years) with independent and/or assisted walking, subjective memory impairment, mild cognitive impairment or mild Alzheimer’s disease (AD) who regularly attended pharmacies underwent the survey. An internal medical examination, a cardiovascular visit, and a short neuropsychological evaluation were conducted for each patient. Demographic, anamnestic, and clinical data were collected anonymously. Results: 279 eligible patients underwent the screening phase. 44% were overweight, 23% obese and 29% hypertensive. 62% of cases showed alterations of supra-aortic trunk with different percentages of stenosis. The neuropsychological evaluation highlighted that 67% of cases were normal according to age and education level, while 18% were in a state condition of cognitive frailty. Mild/moderate cognitive decline, or probably AD, was identified in 14% of cases. Conclusions: A multidisciplinary collaboration between pharmacists and specialist medical doctors is essential in early identification of prodromal symptoms of cognitive impairment and AD. The Prompt detection of the condition in this group of patients allowed the specialists to recommend in-depth diagnostic tests and follow-up procedures to slow the course of the disease. This would give time to carry out adequate caregiver training.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Detection Screening of Cognitive Decline in Patients Over 60 Years: ELDERCARE Study

Putignano,

Forgione,

Fusco

et al. 2024

JAD

View full text Add to dashboard Cite

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“…Building upon the outcomes of comprehensive assessments of older individuals, targeted intervention care should be implemented to address patients’ health needs, including physical health, psychological well-being, nutritional diet, safety, and health education. Targeted care provided by primary healthcare teams, based on a comprehensive assessment of older individuals’ health, can potentially improve their health and quality of life, especially those of advanced age[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

Bao,

Wu,

Cheng

2024

World J Clin Cases

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BACKGROUND The Comprehensive Geriatric Assessment (CGA) was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings. However, there are few reports on its application in hospitalized patients, especially older patients with diabetes and hypertension. AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension. METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022. Among the 80 patients included, 40 received CGA nursing interventions (study group), while the remaining 40 received routine nursing care (control group). The study group's comprehensive approach included creating personalized CGA profiles, multidisciplinary assessments, and targeted interventions in areas, such as nutrition, medication adherence, exercise, and mental health. However, the control group received standard nursing care, including general and medical history collection, fall prevention measures, and regular patient monitoring. After 6 months of nursing care implementation, we evaluated the effectiveness of the interventions, including assessments of blood glucose levels fasting blood glucose, 2-h postprandial blood glucose, and glycated hemoglobin, type A1c (HbA1c); blood pressure indicators such as diastolic blood pressure (DBP) and systolic blood pressure (SBP); quality of life as measured by the 36-item Short Form Survey (SF-36) questionnaire; and treatment adherence. RESULTS After 6 months, the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators, such as fasting blood glucose, 2-h postprandial blood glucose, and HbA1c, as well as blood pressure indicators, including DBP and SBP, compared with the control group (P < 0.05). Quality of life assessments, including physical health, emotion, physical function, overall health, and mental health, showed marked improvements compared to the control group (P < 0.05). In the study group, 38 patients adhered to the clinical treatment requirements, whereas only 32 in the control group adhered to the clinical treatment requirements. The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care (95% vs 80%, P < 0.05). CONCLUSION The CGA nursing intervention significantly improved glycemic control, blood pressure management, and quality of life in hospitalized older patients with diabetes and hypertension, compared to routine care.

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“…The CGA consists of medication assessment, comorbidity, muscle strength, cognitive function, depression, and nutrition. Medication lists were reviewed by a pharmacist, and a potentially inappropriate medication (PIM) list was assessed using the PIM list defined in the COMPASS (COMPrehensive geriatric AsseSSment and multidisciplinary team intervention for hospitalized older adults) study ( 34 ). The burden of comorbidity was quantified using the Charlson comorbidity index (CCI), which contains 19 categories of chronic diseases ( 35 ).…”

Section: Methodsmentioning

confidence: 99%

Impact of malnutrition evaluated by the mini nutritional assessment on the prognosis of acute hospitalized older adults

Kang

Choi²,

Yoo³

et al. 2023

Front. Nutr.

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BackgroundMalnutrition is prevalent among hospitalized older patients. Therefore, this study aimed to investigate the association between nutritional status [assessed using the Mini Nutritional Assessment (MNA) and serum albumin levels] and adverse outcomes in hospitalized older patients. We also aimed to compare the predictive utility of our findings.MethodsThis retrospective cohort study was conducted between January 2016 and June 2020. In total, 808 older patients (aged ≥ 65 years, mean age 82.8 ± 6.70 years, 45.9% male) admitted to the acute geriatric unit were included in our sample. Comprehensive geriatric assessments, including the MNA, were performed. Malnutrition and risk of malnutrition were defined as MNA < 17, albumin < 3.5 g/dL and 17 ≤ MNA ≤ 24, 3.5 g/dL ≤ albumin < 3.9 g/dL, respectively. The primary outcome was that patients could not be discharged to their own homes. The secondary outcomes were overall all-cause mortality, 3-month all-cause mortality, and incidence of geriatric syndrome, including delirium, falls, and newly developed or worsening pressure sores during hospitalization.ResultsPoor nutritional status was associated with older age; female sex; admission from the emergency room; high risk of pressure sores and falls; lower physical and cognitive function; higher depressive score; and lower serum albumin, protein, cholesterol, and hemoglobin levels. In the fully adjusted model, malnutrition assessed using the MNA predicted discharge to nursing homes or long-term care hospitals [odds ratio (OR) 5.822, 95% confidence interval (CI): 2.092–16.199, P = 0.001], geriatric syndrome (OR 2.069, 95% CI: 1.007–4.249, P = 0.048), and 3-month mortality (OR 3.519, 95% CI: 1.254–9.872, P = 0.017). However, malnutrition assessed using albumin levels could only predict 3-month mortality (OR 3.848, 95% CI: 1.465–10.105, P = 0.006). The MNA predicted 3-month mortality with higher precision than serum albumin levels (P = 0.034) when comparing the areas under the receiver operating characteristic curve.ConclusionNutritional risk measured by the MNA was an independent predictor of various negative outcomes in hospitalized older patients. Poor nutritional status assessed by serum albumin levels, the most widely used biochemical marker, could predict mortality, but not the development of geriatric syndrome or discharge location reflecting functional status.

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COMPrehensive geriatric AsseSSment and multidisciplinary team intervention for hospitalised older adults (COMPASS): a protocol of pragmatic trials within a cohort

Cited by 6 publications

References 25 publications

Early Detection Screening of Cognitive Decline in Patients Over 60 Years: ELDERCARE Study

Early Detection Screening of Cognitive Decline in Patients Over 60 Years: ELDERCARE Study

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

Impact of malnutrition evaluated by the mini nutritional assessment on the prognosis of acute hospitalized older adults

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