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DOI: 10.47026/2413-4864-2021-4-79-90
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UDC: 613.98(470)
BBC: Р11(2Рос)287.4

Guryanova E.A., Rechapova E.E., Sidyakina E.S.

Effectiveness of a Comprehensive Geriatric Assessment to Improve the Life Quality of the Elderly and to Ease the Caregivers Burden

Keywords: comprehensive geriatric assessment, quality of life, elderly care, caregiver burden

In the modern world, the number of elderly people with various diseases is growing, they need an appropriate care. Care implementation requires special knowledge, mental and economic expenditures. Ensuring a decent old age for the elderly is one of the problems of modern society. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process for assessing the physical, psychological, functional and socio-economic problems of elderly people in order to develop a comprehensive individual plan for their treatment and rehabilitation. Comprehensive geriatric assessment benefits the elderly population, but the effectiveness of comprehensive geriatric assessment to improve the life quality of the elderly remains unclear. The article provides an overview of studies devoted to studying the effectiveness of using comprehensive geriatric assessment. The article discusses the influence of a comprehensive geriatric assessment on determining the life quality of the elderly, the duration of their stay in the hospital, and relieving the caregivers' burden. In addition, the influence of a comprehensive geriatric assessment on the ability to determine life expectancy, to conduct early diagnosis of major geriatric syndromes, the risk of morbidity and mortality in elderly patients is being considered. It is important that on the basis of a comprehensive geriatric assessment, appropriate rehabilitation programs can be drawn up, and technologies for rehabilitation can be determined.

References

  1. Anisimov V.N., Red’ko A.A., Finagentov A.V., Khavinson V.Kh., Shabrov A.V. Sistemnaya podderzhka povysheniya kachestva zhizni grazhdan starshego pokoleniya v Rossii: problemy i perspektivy [Systemic support for improving the quality of life of citizens of the older generation in Russia: problems and prospects]. Uspekhi gerontologii, 2020, 33, no. 5, pp. 825–837. DOI: 10.34922/AE.2020.33.5.002.
  2. Gur’yanova E.A., Koval’chuk V.V., Tikhoplav O.A., Litvak F.G. Funktsional’naya elektrostimulyatsiya pri vosstanovlenii khod’by posle insul’ta. Obzor nauchnoi literatury [Functional electrical stimulation in the recovery of walking after a stroke. Review of scientific literature]. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya, 2020, 2, no. 3, pp. 244–262.
  3. Klinicheskie rekomendatsii «Starcheskaya asteniya» [Clinical guidelines “Senile asthenia”]. Rossiiskaya assotsiatsiya gerontologov i geriatrov (2018) [Russian Association of Gerontologists and Geriatricians]. Avialable at: http://www.consultant.ru/document/cons_doc_LAW_324981 (Accessed Date 2019, 13).
  4. Lapteva E.S, Aristidova S.N., Ar’ev A.A. Khronometrazh i metodologiya kompleksnoi geriatricheskoi otsenki na primere gorodskogo geriatricheskogo tsentra [Timing and methodology of comprehensive geriatric assessment on the example of a city geriatric center]. Uspekhi gerontologii, 2020, 33, pp. 62–64. DOI: 10.34922/AE.2020.33.1.007.
  5. Lapteva E.S, Ar’ev A.L., Tsutsunava M.R., Ar’eva G.T. Kompleksnaya geriatricheskaya otsenka-reshennye i nereshennye problem [Timing and methodology of comprehensive geriatric assessment on the example of a city geriatric center]. Uspekhi gerontologii, 2021, vol. 34, no. 1, pp. 24–32. DOI: 34922/AE.2021.34.1.003.
  6. Ob utverzhdenii Poryadka okazaniya meditsinskoi pomoshchi po profilyu «geriatriya»: prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsi ot 29.01.2016 no 38n [On approval of the Procedure for the provision of medical care in the “geriatrics” profile: Order of the Ministry of Health of the Russian Federation dated 29.01.2016 No. 38n]. Avialable at: https://www.garant.ru/products/ipo/prime/doc/71251832 (Accessed Date 2019, Oct. 13).
  7. Otsenka aktivnosti patsienta [Assessment of the patient’s activity]. Avialable at: https://rcudprf.ru/patsientam/otsenka-aktivnosti-patsienta/ (Accessed Date 2021, Aug. 24).
  8. Farkhutdinova L.M. Ob osnovakh kompleksnoi geriatricheskoi otsenki [On the basics of a comprehensive geriatric assessment]. Arkhiv” vnutrennei meditsiny, 2019, vol. 9, no. 4, pp. 245–252. DOI: 20214/2226-6704-2019-9-4-245-252.
  9. Applegate W.B., Miller S.T., Graney M.J., Elam J.T., Burns R., Akins D.E. A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. The New England Journal of Medicine (NEJM), 1990, vol. 322(22), pp. 1572–1578. DOI: https://doi.org/10.1056/NEJM199005313222205.
  10. Asplund K., Gustafson Y., Jacobsson C., Bucht G., Wahlin A., Peterson J. et al. Geriatricbased versus general wards for older acute medical patients: a randomized comparison of outcomes and use of Journal of the American Geriatrics Society, 2000, vol. 48(11), pp. 1381–1388. DOI: https://doi.org/10.1111/j.1532-5415.2000.tb02626.x.
  11. Burns R., Nichols L.O., Martindale-Adams J., Graney M.J. Interdisciplinary geriatric primary care evaluation and management: two-year Journal of the American Geriatrics Society, 2000, vol. 48(1), pp. 8–13. DOI: https://doi.org/10.1111/j.1532-5415.2000.tb03021.x.
  12. Cohen H.J., Feussner J.R., Weinberger M., Carnes M., Hamdy R.C., Hsieh F. et al. A controlled trial of inpatient and outpatient geriatric evaluation and management. New England Journal of Medicine, 2002, 346(12), pp. 905–912. DOI: https://doi.org/10.1056/NEJMsa010285.
  13. Counsell S.R., Callahan C.M., Clark D.O., Tu W., Buttar A.B., Stump T.E. et al. Geriatric care management for low-income seniors: a randomized controlled JAMA, 2007, vol. 298(22), pp. 2623–2633. DOI: https://doi.org/10.1001/jama.298.22.2623.
  14. Counsell R., Holder C.M., Liebenauer L.L., Palmer R.M., Fortinsky R.H., Kresevic D.M. et al. Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of acute Care for Elders (ACE) in a community hospital. Journal of the American Geriatrics Society, 2000, vol. 48(12), pp. 1572–1581. DOI: https://doi.org/10.1111/j.1532-5415.2000.tb03866.x.
  15. Covinsky K.E., King J.T., Quinn L.M., Siddique R., Palmer R., Kresevic D.M. et al. Do acute care for elders units increase hospital costs? A cost analysis using the hospital perspective. Journal of the American Geriatrics Society, 1997, 45(6), pp. 729–734. DOI: https://doi.org/10.1111/j.15325415.1997.tb01478.x.
  16. Dann Global elderly care in crisis. Lancet, 2014, vol. 383(9921), p. 927.
  17. Edmans J., Bradshaw L., Franklin M., Gladman J., Conroy S. Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: randomised controlled trial. British Medical Journal (BMJ), 2013, vol. 347, f5874.
  18. Ekdahl A.W., Sjöstrand F., Ehrenberg A., Oredsson S., Stavenow L., Wisten A. et al. Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: a systematic review and meta-analysis. European Geriatric Medicine, 2015, 6(6), pp. 523–540. DOI: https://doi.org/10.1016/j.eurger.2015.10.007.
  19. Ekdahl A.W., Wirehn A.B., Alwin J., Jaarsma T., Unosson M., Husberg M. et al. Costs and effects of an ambulatory geriatric unit (the AGe-FIT study): a randomized controlled trial. Journal of the American Medical Director Association, 2015, 16(6), pp. 497–503. DOI: https://doi.org/10.1016/j.jamda.2015.01.074.
  20. Ekerstad N., Karlson B.W., Dahlin Ivanoff S., Landahl S., Andersson D., Heintz E. et al. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care? Clinical Interventions in Aging, 2016, vol. 12, pp. 1–9.
  21. Fairhall N., Sherrington C., Kurrle S.E., Lord S.R., Lockwood K., Howard K. et al. Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older Journal of the American Medical Director Association, 2015, vol. 16(1), pp. 41–48. DOI: https://doi.org/10.1016/j.jamda.2014.07.006.
  22. Gayton D., Wood-Dauphinee S., de Lorimer M., Tousignant P., Hanley J. Trial of a geriatric consultation team in an acute care hospital. Journal of the American Geriatrics Society, 1987, vol. 35(8), 726–736. DOI: https://doi.org/10.1111/j.1532-5415.1987.tb06350.x.
  23. Higgins J.P., Thompson S.G., Deeks J.J., Altman D.G. Measuring inconsistency in metaanalyses. British Medical Journal (BMJ), 2003, vol. 327(7414), pp. 557–560. DOI: https://doi.org/10.1136/bmj.327.7414.557.
  24. Higgins J.P.T., Li T, Deeks J.J. Chapter 6: Choosing effect measures and computing estimates of effect. Version 6.2, 2021. In: Higgins J., Thomas J., eds. Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration. Available at: https://training.cochrane.org/handbook/current/chapter-06 (Accessed Date 2021, June 16).
  25. Hogan D.B., Fox R.A., Badley B.W., Mann O.E. Effect of a geriatric consultation service on management of patients in an acute care hospital. Canadian Medical Association Journal (CMAJ), 1987, 136(7), pp. 713–717.
  26. Karppi P., Tilvis R. Effectiveness of a Finnish geriatric inpatient assessment. Two-year follow up of a randomized clinical trial on community-dwelling Scandinavian Journal of Primary Health Care, 1995, vol. 13(2), pp. 93–98. DOI: https://doi.org/10.3109/02813439508996743.
  27. Kircher T.T, Wormstall H., Müller P.H., Schwärzler F., Buchkremer G., Wild K. et al. A randomised trial of a geriatric evaluation and management consultation services in frail hospitalised patients. Age and Ageing, 2007, 36(1), pp. 36–42. DOI: https://doi.org/10.1093/ageing/afl102.
  28. Knopp-Sihota J.A., Patel P., Estabrooks C.A. Interventions for the Treatment of Pain in Nursing Home Residents: A Systematic Review and Meta-Analysis. Journal of the American Medical Director Association, 2016, vol. 17(12), 1163.e19–28.
  29. Luo D., Wan X., Liu J., Tong T. Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile Statistical Methods in Medical Research, 2018, vol. 27(6), pp. 1785–1805. DOI: https://doi.org/10.1177/0962280216669183.
  30. Maresova P., Javanmardi E., Barakovic S., Barakovic Husic J., Tomsone S., Krejcar O. et al. Consequences of chronic diseases and other limitations associated with old age – a scoping review. BMC Public Health, 2019, vol. 19(1), p. 1431.
  31. Naglie G., Tansey C., Kirkland J.L., Ogilvie-Harris D.J., Detsky A.S., Etchells E. et al. Interdisciplinary inpatient care for elderly people with hip fracture: a randomized controlled trial. Canadian Medical Association Journal (CMAJ), 2002, vol. 167(1), 25–32.
  32. Nikolaus T., Specht-Leible N., Bach M., Oster P., Schlierf G. A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients. Age and Ageing, 1999, 28(6), pp. 543–550. DOI: https://doi.org/10.1093/ageing/28.6.543.
  33. Parker G., McCue P., Phelps K. et al. What is Comprehensive Geriatric Assessment (CGA)? An umbrella review. Age and Ageing, 2018, vol. 47, no. 1, pp. 149–155.
  34. Partridge J.S., Harari D., Martin F.C., Peacock J.L., Bell R., Mohammed A. et al. Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery. British Journal of Surgery, 2017, vol. 104(6), 679–687. DOI: https://doi.org/10.1002/bjs.10459.
  35. Pilotto A., Cella A., Pilotto A., Daragjati J., Veronese N., Musacchio C. et al. Three Decades of Comprehensive Geriatric Assessment: Evidence Coming From Different Healthcare Settings and Specific Clinical Journal of the American Medical Director Association, 2017, vol. 18(2), pp. 192.e1–192.e11.
  36. Pitkala K.H., Laurila J.V., Strandberg T.E., Kautiainen H., Sintonen H., Tilvis R.S. Multicomponent geriatric intervention for elderly inpatients with delirium: effects on costs and health-related quality of life. Journals of Gerontology-Series A Biological Sciences and Medical Sciences, 2008, vol. 63(1), 56–61. DOI: https://doi.org/10.1093/gerona/63.1.56.
  37. Prestmo A., Hagen G., Sletvold O., Helbostad J.L., Thingstad P., Taraldsen K. et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet, 2015, 385(9978), pp. 1623–1633. DOI: https://doi.org/10.1016/S0140-6736(14)62409-0.
  38. Reuben D.B., Frank J.C., Hirsch S.H., McGuigan K.A., Maly R.C. A randomized clinical trial of outpatient comprehensive geriatric assessment coupled with an intervention to increase adherence to Journal of the American Geriatrics Society, 1999, vol. 47(3), pp. 269–276. DOI: https://doi.org/10.1111/j.1532-5415.1999.tb02988.x.
  39. Rubenstein L.Z., Stuck A.E., Siu A.L., Wieland D. Impacts of geriatric evaluation and management programs on defined outcomes: overview of the evidence. Journal of the American Geriatrics Society, 1991, vol. 39(9 Pt 2):8S–16S discussion 17S–18S.
  40. Saltvedt I., Saltnes T., Mo E.S., Fayers P., Kaasa S., Sletvold O. Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study. Aging Clinical and Exprimantal Research., 2004, vol. 16(4), 300–306. DOI: https://doi.org/10.1007/BF03324555.
  41. Shyu Y.I., Liang J., Wu C.C., Su J.Y., Cheng H.S., Chou S.W. et al. A pilot investigation of the short-term effects of an interdisciplinary intervention program on elderly patients with hip fracture in Journal of the American Geriatrics Society, 2005, vol. 53(5), pp. 811–818. DOI: https://doi.org/10.1111/j.1532-5415.2005.53253.x.
  42. Silverman M., Musa D., Martin D.C., Lave J.R., Adams J., Ricci E.M. Evaluation of outpatient geriatric assessment: a randomized multi-site trial. Journal of the American Geriatrics Society, 1995, 43(7), pp. 733–740. DOI: https://doi.org/10.1111/j.1532-5415.1995.tb07041.x.
  43. Stuck A.E., Siu A.L., Wieland G.D., Adams J., Rubenstein L.Z. Comprehensive geriatric assessment: a meta-analysis of controlled Lancet, 1993, vol. 342(8878), pp. 1032–1036. DOI: https://doi.org/10.1016/0140-6736(93)92884-V.
  44. Vidán M., Serra J.A., Moreno C., Riquelme G., Ortiz J. Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. Journal of the American Geriatrics Society, 2005, 53(9), pp. 1476–1482. DOI: https://doi.org/10.1111/j.15325415.2005.53466.x.
  45. Wan X., Wang W., Liu J., Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol., 2014, vol. 14, p. 135.
  46. Weuve J.L., Boult C., Morishita The effects of outpatient geriatric evaluation and management on caregiver burden. Gerontologist., 2000, vol. 40(4), pp. 429–436. DOI: https://doi.org/10.1093/geront/40.4.429.
  47. Zhongyi Chen, Zhaosheng Ding, Caixia Chen, Yangfan Sun,Yuyu Jiang, Fenglan Liu, Shanshan Wang. Effectiveness of comprehensive geriatric assessment intervention on quality of life, caregiver burden and length of hospital stay: a systematic review and meta-analysis of randomised controlled trials. BMC Geriatr., 2021. 21: 377. DOI: 1186/s12877-021-02319-2.
  48. Zintchouk D., Gregersen M., Lauritzen T., Damsgaard E.M. Geriatrician-performed comprehensive geriatric care in older adults referred to an outpatient community rehabilitation unit: A randomized controlled trial. European Journal of Internal Medicine, 2018, vol. 51, pp. 18–24.

About authors

Gurianova Evgenia A.
Doctor of Medical Sciences, Professor of the Department of Internal Medicine, Chuvash State University, Russia, Cheboksary (z-guryanova@bk.ru; ORCID: https://orcid.org/0000-0003-1519-2319)
Rechapova Enje E.
5th Year Student of the Medicine Faculty, Chuvash State University, Russia, Cheboksary (endzhe.rechapova@mail.ru; ORCID: https://orcid.org/0000-0001-5072-4814)
Sidyakina Ekaterina S.
Head of Department, Republican Clinical Hospital, Russia, Cheboksary (katya@gmail.com; ORCID: https://orcid.org/0000-0003-3843-3496)

Article link

Guryanova E.A., Rechapova E.E., Sidyakina E.S. Effectiveness of a Comprehensive Geriatric Assessment to Improve the Life Quality of the Elderly and to Ease the Caregivers Burden [Electronic resource] // Acta medica Eurasica. – 2021. – №4. P. 79-90. – URL: https://acta-medica-eurasica.ru/en/single/2021/4/9/. DOI: 10.47026/2413-4864-2021-4-79-90.

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