Comprehensive Geriatric Care Research Articles

Anesthetic Challenges in Treating the Older Adult Trauma Patient: an Update

To highlight challenges specific to anesthesia and perioperative care of injured older adults and present novel modalities to improve outcomes in this vulnerable population. We will describe some of the current directions available for anesthesiologists to improve outcomes in the elderly surgical population: interventions to ameliorate perioperative neurocognitive disorders, reversal of treatment with anti-coagulant medications, controversies in pain management, and increasing utilization of regional anesthesia techniques. Finally, frailty assessment and comprehensive geriatric care as efficient method of assessing risk and improving outcomes will be discussed. Perioperative care for older injured adults presents numerous challenges for the anesthesiologist. While novel modalities show promise, ample opportunities to improve still exist.

Peripheral neuropathy in elderly patients

Background: Among others, a peripheral polyneuropathy lead to an increased risk for fall in elderly frail patients. Aims: Therefore, we aimed to investigate the frequency of a polyneuropathy in elderly patients treated in a specialized geriatric unit with a selected neurological expertise. Methods: Patients hospitalized for comprehensive geriatric care in our geriatric unit were selected for the analysis. For proving the presence of a polyneuropathy, we performed extended electrophysiological examinations in patients with a current fall event or at risk for falling. Results: We included in the final analysis 378 patients (median age was 82.1 years (IQR: 77.2 - 87.6 years, 64.6%were female). The diagnosis of polyneuropathy was identified in 340 patients (89.9%); in patients with a current fall event (n=173) a polyneuropathy was identified in 154 subjects (89%); in 31.5% of the cases the polyneuropathy was caused by diabetes mellitus, in 47.6% no etiology could be identified. In patients with polyneuropathy higher rates of individuals aged ≥80 years (67.1% versus 50%; p=0.038), with heart insufficiency (26.5% versus 7.9%; p=0.038) and renal insufficiency (45.6% versus 18.4%; p=0.001) were detected. The diagnosis of a polyneuropathy was associated with the factor renal insufficiency (OR: 2.680; CI: 1.100 - 6.529; p=0.03). Conclusion: Applying specific electrophysiological examinations in the particular setting of a specialized geriatric unit, we detected in a high proportion of patients a polyneuropathy (90%). Our results underline the benefit considering this approach in elderly patients at risk for fall hospitalized for comprehensive geriatric care.

Innovative Model of Interprofessional Geriatric Consultation: Specialized Seniors Clinics.

As the Canadian population ages, healthcare systems have become increasingly interested in exploring new ways to deliver services to frail older adults, and in particular older adults with dementia. The Specialized Seniors Clinics (SSCs) are an innovative integrated network of six outpatient clinics in BC's Fraser Health Authority that utilize interprofessional teams to provide comprehensive geriatric assessments and care planning for frail older adults. The SSCs provided approximately 19,000 appointments in the past fiscal year, and clients and primary care physicians are highly satisfied with the model. This article describes the SSC model and provides reflection on the model development, implementation and standardization processes.

GERIATRICS MICU CO-MANAGEMENT: INTEGRATING GERIATRIC ASSESSMENTS FOR CRITICALLY ILL PATIENTS

Programs like orthogeriatrics, geriatric cardiology have shown to improve outcomes in hospitalized geriatric patients. Our Geriatrics MICU Co-management program is a quality improvement initiative that instigates a partnership approach with critical care medicine in integrating geriatric assessments and build foundation for interdisciplinary care of critically ill patients. MICU (Medical Intensive Care Unit) protocols do not have standard geriatrics assessments integrated in clinical care. An electronic dash-board identifies high risk elderly (HRE) patients admitted at a MICU in a large teaching hospital in Northeast Ohio based on nursing specific screening triggers. A geriatrics co-management team engages in a comprehensive geriatric assessments and care transition. 386 patient were identified using HRE screening triggers in a period of 100 days. 33 % (n=131) were generated as consults for co-management. A pilot review on 131 HRE patients was conducted. 70% (n=93) patients had incident frailty. 93% (n=87) of patients with frailty were diagnosed with incident delirium. 56% (n=74) of patients were newly diagnosed with cognitive impairment. 56 % (N=74) of patients had a medication reduction. An average of 1.23 medication was changed. 85% (n =112) of patients had a warm hand off to the next level of provider on discharge. 90% (n=119) of patients notified improved self-management skills and better understanding of discharge process. The Geri-MICU program demonstrates a patient -centered approach in integrating geriatric assessments for critically ill patients and build foundation of a geriatrics-critical care task force. The program would be a mile stone in optimizing elderly care in critical care units.

Meta-analysis: Effectiveness of Comprehensive Geriatric Care for Elderly Following Hip Fracture Surgery.

Hip fractures may increase mortality and decrease mobility in elderly patients. Effectiveness of comprehensive geriatric care (CGC) has not been verified. A systematic review and a meta-analysis were conducted by searching full-text databases (1988-2018) of Cochrane Library, Clinical Key, Embase, MEDLINE, CINAHL, and ProQuest for randomized controlled trials (RCTs) of CGC following hip fractures. Outcome measures were mortality, activities of daily living, hospital stay, and discharge to institutional setting. Cochrane RoB 2.0, Jadad Quality Score, and Group Reading Assessment were used for analysis. Of the 11 studies included, 8 examined mortality (effect size Z = 2.51, p = 0.01), 5 examined daily activities (effect size Z = 3.31, p = 0.0009), 7 examined length of hospital stay (effect size Z = 0.18, p = 0.85), and 5 examined discharged to an institutional setting (effect size Z = 0.81, p = 0.42). Results showed that CGC decreased mortality and improved daily living activities.

Pilot study of an integrated care model using the geriatric assessment tool.

Older people with type2 diabetes mellitus often suffer from adverse medical and social conditions which are often unrecognized in routine care. Integrated care aims to address all these aspects and centers on the needs of the patient and not the disease. The Accessible Quality Healthcare project in Kosovo, is piloting an integrated care model for patients 65years and over with type2 diabetes mellitus, which also introduces comprehensive geriatric assessment and care planning. In this study two groups (1) acentral working group and (2) amultisectoral implementation group of health and social care professionals were established to develop ageriatric assessment form and an individual care plan form for this project. The groups decided to address the following problems in the geriatric assessment: activities of daily living, urinary incontinence, gait, balance, falls, depression, cognitive function, and frailty. The assessment is carried out by anurse and asocial worker in the living environment of the patient, and the individual care plan is drawn up jointly by adoctor, anurse, and asocial worker and includes (1) problems of the patient, (2) specific goals for each problem and (3) activities to reach the goals. This intervention is one of the first in the health system in Kosovo to implement integrated care in avery vulnerable population. Physical training will be an important tool to tackle many problems detected through the geriatric assessment and which are also associated with type2 diabetes mellitus.

Study of morbidity pattern among geriatric patients attending outpatient department of a rural health training center, Maner of IGIMS, Patna

Background: With increasing life expectancy, number of old age people increased throughout the world, particularly more in the developing countries like India. Globally there are an estimated 605 million people aged 60 years and above. As the ageing population is increasing, the burden of their health problems is on a rise. To provide appropriate care for them there is a need to attain information about their morbidity pattern. Objectives: to study the morbidity pattern among the geriatric patients attending outpatient department of RHTC, Maner of IGIMS, Patna and to find out the difference in health problems between males and females, if any.Methods: This hospital based cross-sectional study was conducted during September 2017 to February 2018 among 98 elderly patients, aged 60 years or above, who attended first time at the Out Patient Department of rural health training center, Maner of IGIMS, Patna and who fulfilled inclusion criterion.Results: In this study majority had normal nutritional status. Amongst morbidity, prevalence of locomotors problems was highest (63.26%) followed by depression (42.85%), refractive error (20.4%), hearing loss (18.2%) and cataract (15.3). Locomotors problems were significantly higher in women (93.75%) as compared to the men (34%). However, the prevalence of depression, refractory error, hearing loss and cataract were not significantly associated with gender.Conclusions: There is a need to deliver comprehensive geriatric health care services for prevention and control of chronic diseases and address the dual burden of disease among the elderly to promote healthy ageing.

A Narrative Review of National Programmes for theElderly in India: The Geriatric Care Policy needs tomainstream Aging in Development

Background In response to the demographic transition sweeping across India which has led to an increasing proportion of older adults in India the National Policy for Older Persons NPOP was instituted in 1999 to promote the health and welfare of senior citizens. In 2011 Indiarsquos National Policy for Senior Citizens was announced and intended to further address several contributing factors. This accounted for the changing demographics of India the changing economy social milieu advancement in medical research science and technology and high levels of destitution prevalent among the elderly rural poor. It intended to cater to the needs of this high proportion of elderly women than men who experienced loneliness and were dependent on children while arguing that it represented to create an age integrated society. This once again reinforced the notion that by increasing the capacity of the family to take care of their older family members through increasing family bonds and intergenerational understanding and support. However it is evident that the actual implementation of this policy particularly in the rural areas has been relatively insignificant and the reality is compounded by the general breakdown of the joint family system and the migration of the younger generation to the towns and cities. Many elderly parents in Indiarsquos villages are left to fend for themselves as waves of migration leaves them alone and unsupported for their basic needs and medical requirements. Though the NPHCE was launched in 2010 and envisaged a tiered system of care provision for the elderly its vertical nature has meant its integration into the community has been marginal. This situational review article primarily focuses on the various facets of elder care policies in India. Since there are challenges to the living conditions of the elderly in India faced by the brunt of modernization urbanization and migration. As a nation gradually being impacted by the aging phenomenon we must adopt practices from other nations who have experienced aging and have taken policy measures to that effect. The focus needs to be on delivering effective social assistance schemes tailored contributory schemes and amend eligibility age and criteria to be of benefit to the rural and urban poor. An appropriate time has come to assess the implementation of our policies for senior citizens and review geriatric healthcare provisions vis a vis demographic trends mainstream aging in development and institutionalize a comprehensive geriatric care policy that is in tune with an aging India.

Impact of Geriatrician-Performed Comprehensive Geriatric Care on Medication Use and Cognitive Function in Older Adults Referred to a Non-Hospital-Based Rehabilitation Unit

Background and PurposeEighty-eight percent of older adults referred to Danish non-hospital-based rehabilitation units used ≥5 regular drugs per day at the beginning of rehabilitation. The aim of the study was to explore whether geriatrician-performed comprehensive geriatric care had an impact on medication use and cognitive function in older adults after a 90-day follow-up. MethodsThere were 368 individuals aged ≥65 years recruited from 2 Danish non-hospital-based rehabilitation units and randomized to geriatric care (the intervention group) or usual care (the control group). The medication adjustment was the key element of the geriatric intervention. The control group received standard rehabilitation with general practitioners as back-up. The outcomes were prevalence of hyperpolypharmacy (≥10 regular medications prescribed concurrently), the change in medication profile, and cognitive function measured using the Mini-Mental State Examination. ResultsIn the intervention group, fewer persons were exposed to hyperpolypharmacy (odds ratio 0.5; 95% confidence interval, 0.3-0.9) compared with the control group after 90 days. The prevalence of use of proton pump inhibitors, loop diuretics, or antiasthmatic inhalers was lower, while the prevalence of cholecalciferol use was higher in the intervention group compared with the control group. The prevalence of other drug use and cognitive function between groups were not different. ConclusionsGeriatrician-performed comprehensive geriatric care may reduce the prevalence of hyperpolypharmacy and optimize the medication profile in older adults referred to a non-hospital-based rehabilitation. No impact on cognitive function was found.

Timely identification of patients with frailty at the 'front door' of acute hospitals.

Early identification of frailty at the front door of the acute hospital is vital to allow rapid comprehensive geriatric assessment and care pathway development in the most appropriate location. This article discusses the importance of developing robust processes to enable early identification and management of frailty in the acute hospital. It also highlights the benefits of developing a dynamic team of professionals at the front door of the acute hospital who are effectively trained to undertake comprehensive assessment. Effective care planning for older people with frailty requires meticulous coordination through collaboration across health and social care and this is demonstrated using an effective model which has been developed in a district general hospital in Scotland.

Geriatrician-performed comprehensive geriatric care in older adults referred to a community rehabilitation unit: A randomized controlled trial

BackgroundOlder adults make increasing demands on all sectors of the healthcare system. We investigated the effect of geriatrician-performed comprehensive geriatric care (CGC) in older adults referred to a community rehabilitation unit. DesignRandomized controlled trial. SettingTwo Danish non-hospital based rehabilitation units. ParticipantsPersons aged 65 or older admitted from home or hospital. InterventionCGC performed by a geriatrician at the rehabilitation unit. OutcomesPrimary outcome was number of hospital admissions and emergency department (ED) visits. Secondary outcomes were number of ambulatory contacts, general practitioner (GP) contacts, activities of daily living (ADL) and overall quality of life (OQoL). Outcomes were measured within 90 days of admission to the rehabilitation units. Results368 persons were randomized: 185 to the intervention group (IG) vs 183 to the control group (CG). Groups were comparable at baseline. The number of hospital admissions and ED visits, ambulatory contacts and out of hour GP visits or phone calls did not differ between the groups. The number of daytime GP consultations and visits or phone and email consultations was lower in the IG (P < 0.001). There were no differences in the mean between the groups for ADL and OQoL, but more participants in the IG improved their OQoL (OR 1.63, 95% CI: 1.07–2.48, P = 0.023). ConclusionGeriatrician-performed CGC in older adults in a community rehabilitation unit had no effect on the secondary healthcare utilization, but may reduce primary healthcare utilization and improve OQoL during the 90-day follow-up period. Trial registrationClinicalTrials.govNCT01506219.

The effect of a gerontology nurse specialist for high needs older people in the community on healthcare utilisation: a controlled before-after study

BackgroundNurse-led models of comprehensive geriatric assessment and care coordination can improve health management as well as reduce hospitalisations for high risk community dwelling older people. This study investigated the effect on healthcare utilisation of systematic case finding to identify high risk older people in the community with a subsequent comprehensive assessment and care coordination intervention by a Gerontology Nurse Specialist based in primary care.MethodsThis was a controlled before-after study design located within primary healthcare practices in Auckland, New Zealand. An intervention model was initiated within two primary healthcare practices and involved a screening tool to identify high risk older people with succeeding gerontology nurse specialist assessment and care coordination. The comparison group included older people who received usual care at three comparable primary healthcare practices. The primary outcome measure was acute hospital admissions. Secondary outcomes included hospital re-admissions, length of stay, emergency department presentations, residential care admissions, and community contacts.ResultsA total of 579 older people were posted the screening tool in the intervention group, with 517 completed screens (89% response rate) formulating the intervention group. A total of 101 older people were identified as high risk from these screens (20%). The comparison group comprised 883 older people. Comparing the intervention and comparison group, no statistical differences were found for hospital admissions, emergency department presentations, hospital re-admissions, length of stay, or residential care admission. Community physiotherapy showed a statistically significant increase for the intervention compared to the comparison group (p = 0.03). Non-significant findings revealed decreased risk of entering residential care and fewer frequent hospital re-admissions for the intervention group when compared with the comparison group.ConclusionsThis specialist nurse-led intervention involving comprehensive assessment and care coordination care did not appear superior to usual care, however, there is benefit to exploring a more robust randomised controlled trial design.Trial registrationRetrospectively registered on 18/09/2017 with the Australian New Zealand Clinical Trials Registry (ANZCTR). Registration number ACTRN12617001332314

Comprehensive geriatric care for frail elderly at home: afeasibility study

To evaluate the feasibility of astudy on the content and effect of comprehensive geriatric care (CGC) at home for frail elderly. Case managers invited new CGC patients of one care organization for participation in the study. At two moments, questionnaires were conducted on (social) functioning, quality of life, perceived problems, perceived informal caregiver burden, and self-management. Information on received care was collected from the patients' medical records, In addition, aquestionnaire was administered to the referring physician. Feasibility was evaluated descriptively on three domains; inclusion, follow up, and data collection. The intended number of 25participants was not reached, mostly because clients did not comply with inclusion criteria, and because case managers felt uncomfortable asking patients for participation in the study. Of the 14participants, 12were followed until the follow-up measurement. Several questionnaire domains appeared difficult to answer for participants. It also appeared difficult to collect information on received care from the medical records. Questionnaire response among general practitioners was 6 out of 11. Due to the vulnerability of the targeted group and logistical challenges, the inclusion of participants for the study was more difficult than originally thought. In combination with the difficulties in data collection, this suggests that alarge-scale study on the content and effect of CGC is not feasible. Qualitative research methodologies, preferably combined with quantitative methods, offer better opportunities to understand the value of CGC for frail elderly living at home.

Early coordinated rehabilitation in acute phase after hip fracture \u2013 a model for increased patient participation

BackgroundStudies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients’ perceived participation and subsequent effect on patients’ function.MethodsA prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. Intervention: coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month.ResultsAt discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls.ConclusionThis model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients’ perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge.Trial registrationClinicalTrials.gov Identifier: NCT03301584 (Retrospectively registered: 4th October 2017).

Developing Health Promotion Strategies to Enhance Clinical Practice Considering Risk Factors for Age-Related Hearing Loss

Health care professionals including physicians, nurses, and audiologists are charged with providing comprehensive geriatric care for millions of aging adults. As baby boomers mature, prevalence of age-related hearing loss (ARHL) among adults aged 45+ years has risen from 30% to 50%. New findings have emerged regarding risk factors affecting ARHL prevalence. Many aging adults have medical comorbidities, such as diabetes, cardiovascular disease, and hypertension, which substantially increase the risk for ARHL. Recent studies highlighted links between cognitive skills, psychological health, and lifestyle choices like exercise and smoking that also relate to hearing loss. Thus, both intrinsic and extrinsic factors influence risk for ARHL. However, many practitioners are unaware of the relationship between such risk factors and ARHL. Therefore, this tutorial article highlights key research findings and summarizes current knowledge for clinical application. Specific audiologic and interdisciplinary strategies for clinical intervention are recommended within a framework of developing community-specific hearing health promotion programs.

優しさを伝えるケア技術 : ユマニチュード(公開講座,第25回日本精神保健看護学会学術集会)

優しさを伝えるケア技術 : ユマニチュード(公開講座,第25回日本精神保健看護学会学術集会)

Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures

The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium. Odds ratios (ORs) and mean differences (MDs) were pooled using either a fixed-effects or a random-effects model, depending on the heterogeneity of the trials included in the analysis. Six RCTs and 1 quasi-RCT provided data from 1840 patients. These data revealed that comprehensive geriatric care may reduce the incidence of perioperative delirium (OR = 0.71; 95% confidence interval [CI], 0.57-0.89; P = .003) and that it was associated with higher cognitive status during hospitalization or at 1 month postoperatively (MD = 1.03; 95% CI, 0.93-1.13; P ≤ .00001). There was no significant difference in duration of perioperative delirium between the 2 treatment groups (MD = -2.48; 95% CI, -7.36 to 2.40; P = .32). Based on the quality of evidence provided, comprehensive geriatric care may reduce the incidence of perioperative delirium. To obtain evidence regarding the merits of comprehensive geriatric care in reducing severity of delirium and shortening the duration of delirium, there is a need for multicenter RCTs with high methodological quality.

Patterns of drug prescriptions in an orthogeriatric ward as compared to orthopaedic ward: results from the Trondheim Hip Fracture Trial\u2014a randomised clinical trial

PurposeIn the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study.MethodsDrugs prescribed at admission and discharge were registered from hospital records. Mobility, function, fear of falling and quality of life were assessed using specific rating scales. Linear regression was used to analyse association between drug changes and outcomes at 4 months.ResultsThe mean age was 83 years, and 74% were females. The mean number (± SD) of drugs in the CGC and OC groups was 3.8 (2.8) and 3.9 (2.8) at inclusion and 7.1 (2.8) and 6.2 (3.0) at discharge, respectively (p = 0.003). The total number of withdrawals was 209 and 82 in the CGC and OC groups, respectively (p < 0.0001), and the number of starts was 844 and 526, respectively (p < 0.0001). A significant negative association was found between the number of drug changes during the hospital stay and mobility and function 4 months later in both groups. However, this association disappeared when adjusting for baseline function and comorbidities.ConclusionThese secondary analyses suggest that there are significant differences in the pharmacological treatment between geriatric and orthopaedic wards, but these differences could not explain the beneficial effect of CGC in the Trondheim Hip Fracture Trial.

TREATMENT SATISFACTION: A NEGLECTED BUT IMPORTANT OUTCOME MEASURE IN OLDER PEOPLE WITH TYPE 2 DIABETES

Objective: To investigate the effect of comprehensive geriatric care (CGC) in elderly referred to a rehabilitation unit. This article describes the considerations behind the study. Design: Participants were randomized to either CGC or standard care. Setting: Participants were recruited from two community care rehabilitation units in Aarhus Municipality, Denmark, in the period between 2012 and 2015. Participants: Inclusion: Elderly patients aged 65 and older admitted from home or hospital. Exclusion: Persons receiving palliative care or assessed by a geriatrician during the past month. Intervention: Medical history, physical examination, blood tests, medication adjustment and follow-up by a geriatrician. The control group received standard care with the general practitioners (GPs) as back-up. Outcomes: Primary outcome: Hospital contacts drawn from national registers. Secondary outcomes: GPs contacts, institutionalization, medication status and mortality collected from national registers and Activities of daily living (ADL), physical and cognitive function and quality of life measures collected by a blinded occupational therapist. All outcomes were assessed at day 10, 30 and 90 after arrival at the rehabilitation unit. Conclusion: A new model of care for elderly referred to community rehabilitation was developed and implemented. The potential benefits of this model were compared with usual care in a community rehabilitation unit in a pragmatic randomized clinical trial. We hypothesized that the geriatrician-performed CGC in elderly referred to a rehabilitation unit will reduce the hospital contacts by 25 % without increase in mortality and in contacts to GPs and home care services. We expect that this model will prevent deterioration in ADL, and physical and cognitive functioning, and reduce the risk of institutionalization. If the results are positive, community rehabilitation services should be encouraged to change their routines for treatment of this population accordingly.

Study of Comprehensive Geriatric Care in Sharkia Governorate

Background: In recent years, there has been a sharp increase in the number of older persons all over the world. The number of people aged 60 years and over is expected to increase to 2 billion by the year 2050. One of the greatest challenges in geriatrics is the provision of optimal comprehensive geriatric care for older adults. Family physicians can improve the early identification of specific problems that are common in the elderly and also shift their focus from disease specific intervention to preventive care. Objectives: To improve the health of geriatrics through identifying health problems among the studied geriatric population in Sharkia governorate and determining the level of the family physicians' knowledge and practice of comprehensive geriatric care in Sharkia governorate. Subjects and methods: A cross-sectional study was conducted, it was conducted in 9 accredited family health centers in Sharkia governorate for one year. The family health centers were selected by stratified random sampling technique from health centers of Sharkia governorate. The sample included 630 elderly person and 52 family physicians. Results: The results of this study declared that the most prevalent self-reported morbidities were, diabetes mellitus (36.7%), hypertension (33.5%) and respiratory disease (20.2%). The results also showed that (76.9%) of the studied family physicians have adequate knowledge about physical problems of the elderly population and (25%) of the studied family physicians have adequate performance in taking personal history, abdominal examination and counseling of the elderly population. Conclusion: The more prevalent self-reported morbidities among the studied geriatric population were, diabetes mellitus, hypertension and respiratory diseases. Most of family physicians had inadequate level of performance as regard physicians performance during dealing with geriatric patients. Recommendations: The study highlighted the need to promote geriatric health care services, regular health checkup and social support by people. Continuous training of family physicians specially in comprehensive geriatric care for providing high quality of care for elderly population.