A medical care model using comprehensive geriatric assessment for community-dwelling older Korean adults. (July 2020)

• Record Type: Journal Article
• Authors: Kang, Min-gu; Kang, Chul-Hwan; Lee, Heeyoung; Yoo, Young-chul; Lee, You-rim; Kim, Kwang-il; Kim, Cheol-Ho
• Is Part Of: Archives of gerontology and geriatrics. Volume 89(2020)
• Publication Date: 2020-07
• Subjects: Comprehensive geriatric assessment -- Medical care model -- Community -- Older adults; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2020.104064
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: The older patients should be assessed to identify risk factors for functional decline. We developed a medical care model using comprehensive geriatric assessment (CGA). The model had a positive effect on the physical function and quality of life. The model is sustainable given the high satisfaction and willingness to re-participate. Abstract: Background: The quality of life of older adults deteriorates when they lose their ability to perform activities of daily living. Therefore, the older adults should be assessed to identify risk factors for functional decline and to correct these factors so that they may live as independently as possible in the community. We developed a medical care model using comprehensive geriatric assessment (CGA) for community-dwelling older patients. Methods: Three hundred and ninety-one older adults who were frail or likely to be frail were selected. CGA was performed before and after the interventions to determine the effect of the interventions. Three interventions—exercise training, nutritional education, and medication reconciliation—were performed for 5.1 ± 0.6 months. Results: A comparison of the results of the first and second assessments revealed that the participants showed improvement in physical function, quality of life, medication, and nutrition. The average gait speed had increased from 0.77 ± 0.17 m/s to 0.89 ± 0.20 m/s ( P < 0.001). For health-related quality of life, the average EuroQol-5 dimension-3L score for each domain decreased significantly. The number of patients with polypharmacy decreased from 181(50 %) to 155(43 %) (P = 0.001) . The number of patients who were at risk of malnutrition or malnourished decreased from 72(20 %) to 45(12 %) ( P < 0.001). The majority of participants were highly satisfied and were willing to participate again. Conclusion: Our medical model based on CGA showed a significantly positive effect on the physical function and quality of life of community-dwelling older adults. Our model may be a promising strategy for improving the care of them.