Skip to main content
SpringerLink
Log in

Comprehensive Geriatric Assessment in the Hospital

  • Chapter
  • First Online:
Comprehensive Geriatric Assessment

Part of the book series: Practical Issues in Geriatrics ((PIG))

Abstract

Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults in order to develop a coordinated management plan. CGA performed in the hospital, especially in dedicated units, have been shown to be consistently beneficial for several health outcomes, including cognitive impairment, institutionalization, hospital readmission, and mortality risk. In contrast, the data are conflicting for posthospital discharge CGA programs including CGA based with transitional care bridge programs. In this chapter, we discuss the importance of CGA made in the hospital compared to that made in other settings, summarizing the most important studies made in hospital setting regarding CGA.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Rubenstein LZ, Stuck AE, Siu AL, Wieland D (1991) Impacts of geriatric evaluation and management programs on defined outcomes: overview of the evidence. J Am Geriatr Soc 39:8S–16S.; discussion 17S-18S. doi:10.1111/j.1532-5415.1991.tb05927.x

    Article  CAS  PubMed  Google Scholar 

  2. Pilotto A, Cella A, Pilotto A, Daragjati J, Veronese N, Musacchio C et al (2017) Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc 18(2):192.e1–192.e11

    Google Scholar 

  3. Rubenstein LZ (2004) Joseph T. Freeman award lecture: comprehensive geriatric assessment: from miracle to reality. J Gerontol A Biol Sci Med Sci 59:473–477

    Article  PubMed  Google Scholar 

  4. Applegate WB, Miller ST, Graney MJ, Elam JT, Burns R, Akins DE (1990) A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. New Engl J Med 322:1572–1578. doi:10.1056/NEJM199005313222205

    Article  CAS  PubMed  Google Scholar 

  5. Arbaje AI, Maron DD, Yu Q, Wendel VI, Tanner E, Boult C et al (2010) The geriatric floating interdisciplinary transition team. J Am Geriatr Soc 58:364–370. doi:10.1111/j.1532-5415.2009.02682.x

    Article  PubMed  Google Scholar 

  6. Asplund K, Gustafson Y, Jacobsson C, Bucht G, Wahlin A, Peterson J et al (2000) Geriatric-based versus general wards for older acute medical patients: a randomized comparison of outcomes and use of resources. J Am Geriatr Soc 48:1381–1388

    Article  CAS  PubMed  Google Scholar 

  7. Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough-Gorr KM (2010) Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 340:c1718–c1718. doi:10.1136/bmj.c1718

    Article  PubMed  PubMed Central  Google Scholar 

  8. Buurman BM, Parlevliet JL, Allore HG, Blok W, van Deelen BA, Moll van Charante EP et al (2016) Comprehensive geriatric assessment and transitional care in acutely hospitalized patients: the transitional care bridge randomized clinical trial. JAMA Intern Med 176:302–309. doi:10.1001/jamainternmed.2015.8042

    Article  PubMed  Google Scholar 

  9. Cohen HJ, Feussner JR, Weinberger M, Carnes M, Hamdy RC, Hsieh F et al (2002) A controlled trial of inpatient and outpatient geriatric evaluation and management. New Engl J Med 346:905–912. doi:10.1056/NEJMsa010285

    Article  PubMed  Google Scholar 

  10. Counsell SR, Holder CM, Liebenauer LL, Palmer RM, Fortinsky RH, Kresevic DM et al (2000) 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. J Am Geriatr Soc 48:1572–1581

    Article  CAS  PubMed  Google Scholar 

  11. Deschodt M, Flamaing J, Haentjens P, Boonen S, Milisen K (2013) Impact of geriatric consultation teams on clinical outcome in acute hospitals: a systematic review and meta-analysis. BMC Med 11:48–48. doi:10.1186/1741-7015-11-48

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ekerstad N, Karlson BW, Dahlin Ivanoff S, Landahl S, Andersson D, Heintz E et al (2017) Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care? Clin Intervent Aging 12:1–9. doi:10.2147/cia.s124003

    Article  Google Scholar 

  13. Ellis G, Whitehead MA, Robinson D, O’Neill D, Langhorne P (2011) Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ 343:1034. doi:http://dx.doi.org/10.1136/bmj.d6553

  14. Van Craen K et al (2010) The effectiveness of inpatient geriatric evaluation and management units: a systematic review and meta-analysis. J Am Geriatr Soc 58:83–92. doi:10.1111/j.1532-5415.2009.02621.x

    Article  PubMed  Google Scholar 

  15. Rubenstein LZ, Abrass IB, Kane RL (1981) Improved care for patients on a new geriatric evaluation unit. J Am Geriatr Soc 29:531–536

    Article  CAS  PubMed  Google Scholar 

  16. Rubenstein LZ, Josephson KR, Wieland GD, English PA, Sayre JA, Kane RL (1984) Effectiveness of a geriatric evaluation unit. A randomized clinical trial. New Engl J Med 311:1664–1670. doi:10.1056/NEJM198412273112604

    Article  CAS  PubMed  Google Scholar 

  17. Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ (1993) Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet (London, England) 342:1032–1036

    Article  CAS  Google Scholar 

  18. Landefeld CS, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J (1995) A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. New Engl J Med 332:1338–1344

    Article  CAS  PubMed  Google Scholar 

  19. Nikolaus T, Specht-Leible N, Bach M, Oster P, Schlierf G (1999) A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients. Age Ageing 28:543–550

    Article  CAS  PubMed  Google Scholar 

  20. Baztan JJ, Suarez-Garcia FM, Lopez-Arrieta J, Rodriguez-Manas L, Rodriguez-Artalejo F (2009) Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis. BMJ 338:b50. doi:10.1136/bmj.b50

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bakker FC, Robben SH, Olde Rikkert MG (2011) Effects of hospital-wide interventions to improve care for frail older inpatients: a systematic review. BMJ Qual Saf 20:680–691. doi:10.1136/bmjqs.2010.047183

    Article  PubMed  Google Scholar 

  22. Hung WW, Ross JS, Farber J, Siu AL (2013) Evaluation of the mobile acute care of the elderly (MACE) service. JAMA Intern Med 173:990–996. doi:10.1001/jamainternmed.2013.478

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hesselink G, Schoonhoven L, Barach P, Spijker A, Gademan P, Kalkman C et al (2012) Improving patient handovers from hospital to primary care: a systematic review. Ann Intern Med 157(6):417–428. doi:10.7326/0003-4819-157-6-201209180-00006

    Article  PubMed  Google Scholar 

  24. Naylor MD, Aiken LH, Kurtzman ET, Olds DM, Hirschman KB (2011) The care span: the importance of transitional care in achieving health reform. Health Aff 30:746–754. doi:10.1377/hlthaff.2011.0041

    Article  Google Scholar 

  25. Naylor MD, Brooten D, Campbell R, Jacobsen BS, Mezey MD, Pauly MV, Schwartz JS (1999) Comprehensive discharge planning and home follow-up of hospitalized elders: a randomized clinical trial. JAMA 281:613–620. doi:10.1001/jama.281.7.613

    Article  CAS  PubMed  Google Scholar 

  26. Siu AL, Kravitz RL, Keeler E, Hemmerling K, Kington R, Davis JW et al (1996) Postdischarge geriatric assessment of hospitalized frail elderly patients. Arch Intern Med 156:76–81. doi:10.1001/archinte.1996.00440010094012

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation–Frailty Area, Galliera Hospital NR-HS, Genova, Italy

    Alberto Pilotto & Nicola Veronese

Authors
  1. Alberto Pilotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola Veronese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Pilotto .

Editor information

Editors and Affiliations

  1. Geriatric Care, Orthogeriatrics and Rehab, Ospedali Galliera, Genoa, Italy

    Alberto Pilotto

  2. Dept. of Aging and Health, St. Thomas Hospital, London, United Kingdom

    Finbarr C. Martin

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Pilotto, A., Veronese, N. (2018). Comprehensive Geriatric Assessment in the Hospital. In: Pilotto, A., Martin, F. (eds) Comprehensive Geriatric Assessment. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-62503-4_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-62503-4_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-62502-7

  • Online ISBN: 978-3-319-62503-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation