Outpatient comprehensive geriatric assessment: Effects on frailty

Objectives: The prevention and treatment of frailty is a great challenge to health care in the future. Elderly receiving Comprehensive Geriatric Assessment (CGA) as hospital inpatients have decreased institutionalization and mortality. This study aimed to analyze the effects of outpatient CGA on frailty in community dwelling elderly people with multimorbidity. Methods: The Ambulatory Geriatric Assessment - Frailty Intervention Trial (AGe-FIT)was a randomized controlled trial with an intervention group (n = 208) and a control group (n = 174). Frailty was one of the secondary outcomes. Participants were community dwelling elderly people with multimorbidity (N = 382). Inclusion criteria were: age ≥75 years, ≥3 diagnoses per ICD-10, and ≥3 inpatient admissions during 12 months prior to study inclusion. The intervention group received CGAbased care in an Ambulatory Geriatric Unit by a multidisciplinary team. The control group received usual care. Frailty was classified with the criteria from the Cardiovascular Health Study (CHS) at baseline and at 24 months. Results: After 24 months, there was a significant difference in proportion of patients classified as pre-frail between the intervention group and control group, p = 0.029. The mortality was high, 18.8% (n = 39) in the intervention group and 27% (n = 47) in the control group. This was expected considering the high risk of mortality related to old age, multimorbidity and frailty. Conclusion: These results suggest that outpatient CGA and subsequent interventions could have an important role in delaying development of frailty. (Less)