Application Of Comprehensive Geriatric Assessment Research Articles

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients.

Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease (COPD) patients and reduce the quality of life of patients, but also affect the treatment effect and long-term prognosis. Therefore, it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression. To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents. In this retrospective study, 60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group. The control group was given routine nursing, and the observation group was given comprehensive assessment. Clinical symptoms, quality of life [COPD assessment test (CAT) score], anxiety and depression Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were compared between the two groups. CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge, and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge. The average score was 22.1 (P < 0.05). In the observation group, HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge, and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge. The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge, and from an average of 14.1 at admission to an average of 11.8 at discharge. The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients' clinical symptoms and quality of life, and can effectively reduce patients' anxiety and depression.

Expert consensus on diagnosis and treatment for elderly with thyroid diseases in China (2021).

In order to improve the diagnosis and treatment of senile thyroid diseases in China and to promote healthy aging, the Endocrine Metabolic Diseases Group of the Chinese Geriatrics Society, and the Thyroid Group of the Chinese Society of Endocrinology jointly drafted the “Expert consensus on diagnosis and treatment for Chinese elderly with thyroid diseases” (referred to as consensus). The Consensus consists of five parts that set 40 recommendations on main clinical issues. The consensus emphasizes clinical focus on the age‐related changes of the hypothalamus‐pituitary‐thyroid axis in the elderly, and it recommends application of comprehensive geriatric assessment to thoroughly evaluate the impact of thyroid diseases and relevant intervention on overall health condition. Meanwhile, it recommends generalization of screening for hypothyroidism during admission to nursing institution or hospital, and routine health check‐ups. Furthermore, it develops individualized stratified management on hyperthyroidism, hypothyroidism, thyroid nodules, and differentiated thyroid carcinoma in the elderly distinguished from the youngers, including treatment regimen, control ranges, and flowcharts for diagnosis and treatment. The Consensus will provide the basis for clinical decisions and health management of thyroid diseases in the elderly by geriatrician, endocrinologist, and general practitioners.

Application of comprehensive geriatric assessment in predicting early mortality among elder patients with B-cell lymphoma receiving immunochemotherapy.

Early mortality, defined as death within 120days after initiated antitumor therapy, is an important issue especially for elder patients with B-cell lymphoma. This study aimed to evaluate the clinical value of comprehensive geriatric assessment (CGA) in early mortality prediction in elderly patients with B-cell lymphoma receiving immunochemotherapy. Seventy-six consecutive patients with newly diagnosed B-cell lymphoma receiving immunochemotherapy from a medical center in Taiwan were prospectively enrolled. Patients were divided into fit (n=49) and frail (n=27) groups per pretreatment CGA for early mortality comparison. The early mortality rate in our patient cohort was 16% (n=12): from 6% in patients with no CGA domain impairment to 43% in patients with ≥4 CGA domain impairment. The early mortality rate was 6% and 33% in fit and frail patients (odds ratio, 7.67; 95% CI, 1.86-31.6; P=.005), respectively. Frailty was the significant predictor for early mortality in univariate and multivariate analysis. In this study, the number of geriatric domain impairment is positively associated with the early mortality risk in elderly patients with B-cell lymphoma. Therefore, CGA can help clinicians to identify the risk of early mortality in elderly patients and provide alternative treatment.

Systematic review on effects of comprehensive geriatric assessment among patients with hip fractures

Objective To comprehensively review the effect of comprehensive geriatric assessment (CGA) on reducing the incidence of delirium, shortening the length of stay and reducing the morbidity among elderly patients with hip fractures. Methods From June 2017 to February 2018, we retrieved the MEDLINE, EMBASE, PubMed, CENTRAL, PsycINFO, China Biology Medicine, China National Knowledge Infrastructure (CNKI) , Vip Database (VIP) and WanFang data published from establishing database to January 2018. We collected the randomized controlled trials and clinical trials on the application of comprehensive geriatric assessment in elderly patients with hip fractures. Two researchers independently explored literature, screen literature and assess the quality of the included literature according to the inclusion and exclusion criteria, and extract the data. ReManv 5.3 was used to Meta-analysis. Results A total of 14 literature were enrolled and RCT. Meta-analysis showed that there was statistical differences in the incidence of delirium [Z=3.33, P=0.001, OR=0.82, 95%CI (0.74-0.92) ]and the morbidity within half a year [Z=2.89, P=0.004, OR=0.66, 95%CI (0.49-0.87) ], function losing rate [Z=2.92, P=0.003, OR=0.82, 95%CI (0.66-0.92) ]but no statistical difference in the length of stay (Z=1.32, P=0.19) between the CGA group and control group. Conclusions CGA can reduce the incidence of delirium among elderly patients with hip fractures after surgery. Compared with the CGA based on elderly ward, CGA based on agile team follow-up has good effects which can reduce the morbidity within half a year and function losing rate of patients. Key words: Aged; Meta-analysis; Comprehensive geriatric assessment; Hip fractures; Delirium; Length of stay; Mortality; Systematic review

Study on the application of comprehensive geriatric assessment in diffuse large B cell lymphoma

The incidence of elderly patients with diffuse large B cell lymphoma(DLBCL)are increasing year by year.Elderly patients have great heterogeneity.How to properly stratify these patients and give them the most suitable treatment is the challenge we are facing.Comprehensive geriatric assessment(CGA)conduct a comprehensive assessment of the patients from the perspective of gerontology, which is helpful to judge the prognosis, to evaluate the tolerance of treatment, to further guide the treatment, and to accurate treatment of elderly DLBCL.This article reviews the research on the application of CGA in DLBCL at home and abroad, so as to provide evidence for developing the appropriate comprehensive evaluation system for the elderly patients with DLBCL. Key words: Comprehensive geriatric assessment; Lymphoma, B cell

Chinese expert consensus on the application of comprehensive geriatric assessment for the elderly.

Comprehensive geriatric assessment is the major approach in screening geriatric syndrome. The aim of this expert consensus is to supply standard operating procedures for clinical practice of comprehensive geriatric assessment in China.

Interpretation of Chinese experts' consensus on the application of comprehensive geriatric assessment

Interpretation of Chinese experts' consensus on the application of comprehensive geriatric assessment

To enhance clinical application of comprehensive geriatric assessment in elderly inpatients with non-cardiac surgical operation

In this commentary article, we introduce the definition, evaluative contents and methods of comprehensive geriatric assessment (CGA), as well as its successful application in Western countries. CGA is a multidisciplinary diagnosis and treatment process that identifies medical, psychosocial, and functional capabilities of elderly adults to develop plans including overall treatment, nursing, and follow-up to maximize overall health with aging. How to change this situation has become an important challenge due to the significant increase in postoperative complications, mortality, and treatment costs for elderly patients with surgical diseases. Current clinical evidence from Western countries supports that CGA can significantly improve recovery of function, reduce complications and mortality, greatly cut down medical cost, and improve medical utility of elderly patients with burn, trauma, and surgical diseases. Therefore, we advocate that CGA should be routinely used in elderly inpatients before non-cardiac surgical operation in our country.

Comprehensive geriatric assessment of a patient with complex needs.

This is the third in a short series that presents case study examples of the application of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic assessment model, which is designed to determine a frail older person's medical and mental health status, as well as functional, social and environmental issues. When undertaken by nurses, it can enable individualised care planning. The case study presented explores the application of CGA with an 89-year-old patient with complex health and social care needs. It demonstrates how a hospital admission was avoided and the patient's health outcomes improved, by using a nurse-led systematic approach to assessment and by careful consideration of CGA domains.

The Recognition and Application of Comprehensive Geriatric Assessment from Chinese Geriatricians

The purpose of this study was to unveil the current status of Chinese geriatricians and appeal to an imperative reform in geriatric clinical practice