Geriatric age
Pro Research Analysisby 
Searched over 200M research papers for "geriatric age"
Understanding Geriatric Age: Key Insights and Assessments
Comprehensive Geriatric Assessment (CGA)
Definition and Importance
Comprehensive Geriatric Assessment (CGA) is a multidisciplinary diagnostic and treatment process that evaluates the medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize their overall health as they age 13. This assessment is crucial as it helps identify key areas such as activities of daily living, cognition, mood, social supports, gait and falls, nutrition, sensory impairments, incontinence, polypharmacy, elder abuse, pressure sores, pain, and advance directives 1.
Effectiveness Across Settings
The effectiveness of CGA can vary depending on the healthcare setting. Home-based and hospital CGA programs have shown consistent benefits for several health outcomes, while the data for post-hospital discharge CGA programs and outpatient CGA consultations are mixed 3. Tailored CGA programs are particularly beneficial for older frail patients, especially those undergoing preoperative assessments or those with specific conditions like cancer and cognitive impairments 3.
Prevalence of Geriatric Syndromes
Common Syndromes
Geriatric syndromes such as frailty, sarcopenia, weight loss, and dementia are highly prevalent among older adults and significantly impact their quality of life, disability, and mortality 2. Despite their prevalence, these conditions are often under-recognized. For instance, a study using the Rapid Geriatric Assessment (RGA) tool found that 41.0% of older adults were pre-frail, 30.4% were frail, 42.9% had sarcopenia, 29.3% were at risk for weight loss, and 28.1% screened positive for dementia 2.
Screening and Management
The RGA, which includes tools like the FRAIL scale, SARC-F, Simplified Nutritional Appetite Questionnaire (SNAQ), and Rapid Cognitive Screen (RCS), is recommended for annual screening of individuals aged 65 and older as part of the Medicare Annual Wellness Visit 2. Early identification and management of these syndromes can significantly improve outcomes for older adults.
Psychological and Ethical Considerations
Psychological Issues
Older adults are more likely to develop physical disabilities, depression, and cognitive impairments as they age, particularly those in the 80-89 age bracket 56. Effective patient-clinician communication is essential to address these issues and avoid ethical dilemmas that may arise from complex medical and psychosocial concerns 56.
Depression Screening
The Geriatric Depression Scale-15 (GDS-15) is a validated tool for screening depression in older adults. It has a pooled sensitivity of 0.80 and specificity of 0.79, making it a reliable tool, especially for those with normal cognitive function 7. However, its accuracy is slightly lower among older adults with cognitive impairments 7.
Geriatric Assessment in Specific Conditions
Cancer Care
In oncology, chronological age alone is a poor indicator of an older adult's physiological and functional status. A geriatric assessment provides a comprehensive understanding of the patient's condition, helping oncologists make better-informed treatment decisions 8. This approach evaluates physical function, cognition, nutrition, comorbidities, psychological status, and social support, facilitating personalized care 8.
Hematologic Malignancies
For older patients with hematologic malignancies, geriatric assessments can detect impaired domains that may predict mortality and treatment-related toxicity. These assessments are crucial even for patients with a good performance status, as they can identify risks that are not apparent through traditional measures 4.
Conclusion
The geriatric age group, typically defined as individuals aged 65 and older, faces unique medical, psychological, and social challenges. Comprehensive Geriatric Assessment (CGA) and tools like the Rapid Geriatric Assessment (RGA) and Geriatric Depression Scale-15 (GDS-15) are essential for identifying and managing these challenges. Tailored approaches in various healthcare settings, particularly for conditions like cancer and hematologic malignancies, can significantly improve the quality of life and outcomes for older adults. Effective communication and ethical considerations are also critical in providing holistic care to this growing population.
Sources and full results
Most relevant research papers on this topic
Comprehensive geriatric assessment: making the most of the aging years.
Comprehensive geriatric assessment evaluates physical, psychosocial, and environmental factors impacting the well-being of older individuals, focusing on daily living, cognition, mood, social supports, gait and falls, nutrition, and more.
Highly CitedHigh prevalence of geriatric syndromes in older adults
The prevalence of geriatric syndromes like frailty, sarcopenia, weight loss, and dementia is high in older adults across all care continuums, and screening for these conditions can improve outcomes.
Observational Study
Rigorous JournalHighly CitedThree Decades of Comprehensive Geriatric Assessment: Evidence Coming From Different Healthcare Settings and Specific Clinical Conditions.
Comprehensive geriatric assessment (CGA) is a multidisciplinary tool that helps optimize overall health in older adults, with benefits varying by healthcare setting and specific clinical conditions.
Systematic ReviewHighly CitedGeriatric assessment in older patients with a hematologic malignancy: a systematic review
Geriatric assessment is crucial for detecting impairments in older patients with hematologic malignancies, which may predict mortality and increase the risk of treatment-related toxicity, treatment non-completion, and healthcare service use.
Systematic ReviewHighly CitedPsychological Problem in Geriatric Age Group
Geriatric care faces complex medical and psychosocial challenges, requiring better patient-clinician communication and awareness-raising initiatives to improve their quality of life.
Performance of the Geriatric Depression Scale-15 with Older Adults Aged over 65 Years: An Updated Review 2000-2019
The GDS-15 is more accurate for screening depression in older adults with normal cognitive function, but its diagnostic accuracy is slightly lower in those with cognitive impairment.
Meta-AnalysisFunctional versus chronological age: geriatric assessments to guide decision making in older patients with cancer.
Geriatric assessments provide a more comprehensive understanding of the functional and physiological age of older cancer patients, guiding treatment decisions and enhancing personalized care.
Very Rigorous JournalHighly CitedThe 5Ms of Geriatrics in Gastroenterology: The Path to Creating Age-Friendly Care for Older Adults With Inflammatory Bowel Diseases and Cirrhosis
The 5M framework from geriatrics can help create age-friendly care for older adults with inflammatory bowel diseases and cirrhosis by focusing on medications, mind, mobility, multicomplexity, and what matters most.
Very Rigorous JournalDo geriatricians truly welcome ageing?
Geriatricians may harbor attitudes that unconsciously tolerate or amplify ageism in society, healthcare systems, and older people, potentially hindering gerontologically attuned healthcare.
Rigorous Journal