Special Issue "Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive"

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: 31 August 2019

Special Issue Editor

Guest Editor
Dr. G. Darryl Wieland

1. Geriatric Research, Education and Clinical Center [GRECC], Durham VA Medical Center, NC, USA
2. Center for Population Health and Aging, Duke University, Durham, NC, USA
Website | E-Mail
Interests: comprehensive geriatric assessment; population health management; geriatric case-mix and risk modeling; models of geriatric care; long-term care; geriatric workforce development

Special Issue Information

Dear Colleagues,

Geriatric assessment—broadly defined—is the foundation of care for frail elderly people at risk for functional decline, death, and long-term institutionalization. Its key feature is ascertainment of multiple dimensions of health and health risks—not only medical, but functional, cognitive, psychological, and socioeconomic status. This multidimensionality is key to systematic screening and targeting to uncover frail, at-risk elderly people in their neighborhoods, homes, and at various other service contact points, for more intensive evaluation, i.e., “comprehensive geriatric assessment” (CGA)—a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional limitations of a frail older person to develop a coordinated plan to maximize overall health with aging.

CGA imbedded in different geriatric care models—in the community and in institutions—has been studied for years, with evidence supporting the efficacy of some models in improving outcomes. In fact, early successes are partly responsible for the spread and differentiation of CGA-based programs, involving teams of specially trained health professions, together with the continued growth in numbers of frail and at-risk elderly in demographically post-transition populations. CGA also supports various “co-care” or collaborative approaches with orthopedics, oncology, surgery, and other disciplines. Developing countries—also rapidly aging and improving their services resources—have an emerging interest in geriatric medicine and care systems, including adaptation of practice and CGA technologies.

We invite international submissions describing new or established CGA-oriented or based processes, technologies and models of care, particularly welcoming evaluations, quasi-experiments, and randomized trials aimed at establishing their outcomes, costs, and value.

Dr. G. Darryl Wieland
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Comprehensive geriatric assessment
  • Geriatric screening/targeting
  • Geriatric multi- and interdisciplinary team care
  • Geriatric care models
  • Geriatric collaborative care
  • Frailty
  • Geriatric syndromes
  • Geriatric care outcomes

Published Papers (5 papers)

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Research

Open AccessArticle
The Relationship of Balance Disorders with Falling, the Effect of Health Problems, and Social Life on Postural Balance in the Elderly Living in a District in Turkey
Received: 11 March 2019 / Revised: 9 May 2019 / Accepted: 15 May 2019 / Published: 17 May 2019
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Abstract
The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 [...] Read more.
The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 community-dwelling elderly individuals with a mean age of 73.99 ± 6.6 years were enrolled after being selected by stratified random sampling. The study was performed as a face-to-face survey in the homes of elderly individuals. Sociodemographic and medical data were obtained from elderly individuals using the Elderly Identification Form. Balance disorders were determined using the Berg Balance Scale (BBS). In this study, the prevalence of balance disorders was found to be 34.3% in the community-dwelling elderly. Older age, physical disability, having four or more chronic illnesses, the presence of incontinence, having a history of falls, not walking regularly, absence of free time activity, and obesity were found to be associated with an increased prevalence of balance disorders. Balance disorders are commonly seen in the elderly and may be triggered by a variety of biological and social factors. It is crucial to develop and implement national health and social policies to eliminate the causes of this problem, as well as to prioritize preventive health services in the ever-increasing elderly population. Full article
Open AccessArticle
Comprehensive Geriatric Assessment and Nutrition-Related Assessment: A Cross-Sectional Survey for Health Professionals
Received: 26 December 2018 / Revised: 9 February 2019 / Accepted: 12 February 2019 / Published: 15 February 2019
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Abstract
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related [...] Read more.
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related assessments. (2) Methods: We conducted a questionnaire survey on clinical use of CGA, assessment of sarcopenia/sarcopenic dysphagia/cachexia, and defining nutritional goals/the Nutrition Care Process/the International Classification of Functioning, Disability, and Health (ICF)/the Kuchi–Kara Taberu Index. (3) Results: The number of respondents was 652 (response rate, 12.0%), including 77 who used the CGA in the general practice. The univariate analyses revealed that participants using the CGA tended to assess sarcopenia (P = 0.029), sarcopenic dysphagia (P = 0.001), and define nutritional goals (P < 0.001). Multivariate logistic regression analyses for the CGA usage revealed that using ICF (P < 0.001), assessing sarcopenia (P = 0.001), sarcopenic dysphagia (P = 0.022), and cachexia (P = 0.039), and defining nutritional goals (P = 0.001) were statistically significant after adjusting for confounders. (4) Conclusions: There are correlations between the use of CGA and evaluation of sarcopenia, sarcopenic dysphagia, and cachexia and nutritional goals. Full article
Open AccessFeature PaperArticle
Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program
Received: 6 December 2018 / Revised: 22 January 2019 / Accepted: 24 January 2019 / Published: 29 January 2019
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Abstract
The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults [...] Read more.
The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs. Full article
Open AccessArticle
Feeling Respected as a Person: a Qualitative Analysis of Frail Older People’s Experiences on an Acute Geriatric Ward Practicing a Comprehensive Geriatric Assessment
Received: 18 December 2018 / Revised: 18 January 2019 / Accepted: 24 January 2019 / Published: 25 January 2019
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Abstract
Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary [...] Read more.
Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”. Full article
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Open AccessFeature PaperArticle
Point of Care Quantitative Assessment of Muscle Health in Older Individuals: An Investigation of Quantitative Muscle Ultrasound and Electrical Impedance Myography Techniques
Received: 28 November 2018 / Revised: 8 December 2018 / Accepted: 13 December 2018 / Published: 16 December 2018
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Abstract
Background: Muscle health is recognized for its critical role in the functionality and well-being of older adults. Readily accessible, reliable, and inexpensive methods of measuring muscle health are needed to advance research and clinical care. Methods: In this prospective, blinded study, 27 patients [...] Read more.
Background: Muscle health is recognized for its critical role in the functionality and well-being of older adults. Readily accessible, reliable, and inexpensive methods of measuring muscle health are needed to advance research and clinical care. Methods: In this prospective, blinded study, 27 patients underwent quantitative muscle ultrasound (QMUS), standard electrical impedance myography (sEIM), and handheld electrical impedance myography (hEIM) of the anterior thigh musculature by two independent examiners. Subjects also had dual-energy X-ray absorptiometry (DEXA) scans and standardized tests of physical function and strength. Data were analyzed for intra- and inter-rater reliability, along with correlations with DEXA and physical measures. Results: Measures of intra- and inter-rater reliability were excellent (>0.90) for all QMUS, sEIM, and hEIM parameters except intra-rater reliability of rectus femoris echointensity (0.87–0.89). There were moderate, inverse correlations between QMUS, sEIM, and hEIM parameters and measures of knee extensor strength. Moderate to strong correlations (0.57–0.81) were noted between investigational measures and DEXA-measured fat mass. Conclusions: QMUS, sEIM and hEIM were highly reliable in a controlled, same-day testing protocol. Multiple correlations with measures of strength and body composition were noted for each method. Point-of-care technologies may provide an alternative means of measuring health. Full article
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