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| Name | Class |
|---|---|
| University Hospital, Angers | OTHER_GOV |
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The comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological, and functional capabilities of an elderly person, in order to develop a coordinated and integrated plan for treatment. It represents the first stage of the most appropriate care for elderly people who are frail or who cannot perform at least three daily tasks unaided.
It has been shown that the integration of CGA in the decision-making and care management at hospital improves inpatient's health and functional status, and reduces mortality rate and healthcare expenditures. The effects of CGA in daily practice of general practitioners remain unknown.
Implementation of a systematic CGA for every older old community-dwellers performed by a general practitioner remains yet difficult because of number of issues. First, although the number of older old community-dwellers keeps increasing, the number of health care professional with geriatric skills does not. Second, CGA is a complex and time-consuming process. Third, CGA requires a multidisciplinary geriatric team that cannot support alone the care of all frail older old community-dwellers due to their limited number. An implication of non-geriatricians in CGA is therefore required.
Recently, it was confirmed that CGA cannot be applied to all older adults, and that the best compromise could be the use of a two-step approach. The first step is the identification by non-geriatricians of elderly inpatients at high risk of adverse outcomes using a screening tool, and the second step is a CGA by geriatricians with a diagnosis purpose.
None of existing tools used for screening is adapted to the population of elderly people who visit general practitioners.Thus, healthcare professionals working in ED need a simple, standardized and brief geriatric assessment (BGA) to identify as soon as possible frail older old community-dwellers requiring specialized geriatric care.
The investigators hypothesized that a BGA older old community-dwellers carried out by a general practitioner could predict the adverse health events (i.e. hospitalization, institutionalisation, medical consultations and death) occurring during a 6-months follow-up period before the evaluation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Seniors | The study will be based on a 6-months assessment period, with two consecutive monitoring visits on enrollment. Patient follow-up after 3 months will be conducted by telephone and monitoring after 6 months will be carried out as part of a routine consultation. Each subject will have a BGA (Brief Geriatric assesment). |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of non planned hospitalization by subjects | The BGA test will include the following criteria:
All following adverse health events occurring during a 6-months period of follow-up :
| Hospitalization between inclusion and follow up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of subjects' institutionnalized | Institutionnalization between inclusion and follow up at 3 or 6 months | |
| Number of dead subjects | Death between inclusion and follow up at 3 or 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of non planned consultations by subjects | Number of non planned consultations between inclusion and follow up at 3 or 6 months |
Inclusion Criteria:
Eligible patients are those who meet the following inclusion criteria:
Exclusion Criteria:
Patients are ineligible if :
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adults aged 80 and over
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| Name | Affiliation | Role |
|---|---|---|
| Gilles Berrut, PhD | Nantes University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nord Pas de Calais | Leers | 59115 | France |
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