Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 25 July 2024 | Viewed by 5192

Special Issue Editors


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Guest Editor
1. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy
2. Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
Interests: geriatric care; comprehensive geriatric assessment; multidimensional prognostic index; gerontechnology; gastroenterology

Special Issue Information

Dear Colleagues,

Recently there has been extensive literature that suggested that frailty should be identified using a multidimensional approach, a novel approach that permits to better understand the needs of older people. For example, the prevalence of frailty and pre-frailty in older populations, using the multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment (CGA) are extremely high, particularly in some settings, such as nursing homes and hospitals. Moreover, a multidimensional approach could be useful in identifying the pathophysiological mechanisms of clinical frailty useful to understand the trajectory from healthy aging to frailty, including the role of the individual response to chronic diseases that seems to be associated with clinical frailty. 

In this Special Issue, we invite authors to submit works regarding the importance and use of CGA in older people for a better understanding of frailty from a multidimensional point of view, including the functional and psychosocial, as well as the biological and genetic factors related to clinical frailty. Both reviews (narrative or systematic) and original works (also in terms of intervention studies) are welcome for this Special Issue.

Dr. Nicola Veronese
Prof. Dr. Alberto Pilotto
Guest Editors

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Keywords

  • frailty
  • multidimensional
  • comprehensive geriatric assessment
  • multidimensional prognostic index
  • prognosis
  • older people

Published Papers (3 papers)

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Research

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11 pages, 1321 KiB  
Article
Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project
by Wanda Morganti, Nicola Veronese, Marina Barbagelata, Alberto Castagna, Carlo Custodero, Luisa Solimando, Marianna Ilarj Burgio, Sofia Elena Montana Lampo, Emanuele Seminerio, Gianluca Puleo, Barbara Senesi, Lisa Cammalleri, Giovanni Ruotolo, Carlo Sabbà, Mario Barbagallo and Alberto Pilotto
J. Clin. Med. 2023, 12(18), 6026; https://doi.org/10.3390/jcm12186026 - 18 Sep 2023
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Abstract
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed [...] Read more.
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland–Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people. Full article
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20 pages, 1950 KiB  
Article
Comprehensive Geriatric Assessment and Quality of Life Aspects in Patients with Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC)
by Anna Winter, Stefan M. Schulz, Marc Schmitter, Urs Müller-Richter, Alexander Kübler, Sylvia Kasper and Stefan Hartmann
J. Clin. Med. 2023, 12(17), 5738; https://doi.org/10.3390/jcm12175738 - 03 Sep 2023
Cited by 2 | Viewed by 1012
Abstract
To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric [...] Read more.
To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric assessment (CGA) was performed on 21 r/m HNSCC patients at two defined assessments, and the QoL aspects and the impact of descriptive data were evaluated. The Kolmogorov–Smirnov test, Spearman’s rho correlation, and two-way mixed ANOVA were used for statistical analysis. All patients were found to be “frail”. Pain, fatigue, and the burden of illness were the highest-rated symptoms. Oral function and orofacial appearance were highly impaired. A significant impact of descriptive data on the CGA and QoL results was found (all p ≤ 0.05). Thus, the CGA results revealed high frailty, severe comorbidities, and high impairments in QoL aspects. The CGA and QoL results were negatively affected by the primary HNSCC treatment approach, the need for prosthetic treatment, and worse oral functional capacity. Therefore, frailty in r/m HNSCC patients seems to be multidimensional. The evaluation of the CGA and QoL aspects in r/m HNSCC patients can be recommended to detect special needs, organize aftercare, and improve the support for frail and vulnerable cancer patients to create a multidisciplinary treatment approach. Full article
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Review

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11 pages, 271 KiB  
Review
Pre-Therapeutic Assessment of Older People in Sub-Saharan Africa: Introduction to the Comprehensive Geriatric Assessment
by Marie-Josiane Ntsama Essomba, Berthe Sabine Esson Mapoko, Junette Arlette Metogo Mbengono, Nadine Simo-Tabue, Andre Pascal Kengne, Simeon Pierre Choukem, Eugène Sobngwi, Jacqueline Ze Minkande and Maturin Tabue Teguo
J. Clin. Med. 2024, 13(6), 1801; https://doi.org/10.3390/jcm13061801 - 21 Mar 2024
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Abstract
Objectives: With the ongoing epidemiological transition in sub-Saharan Africa (SSA), conditions that require invasive treatment (surgery, cancer, and anaesthesia, etc.) will become increasingly common. Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process aimed at identifying older people at risk of negative [...] Read more.
Objectives: With the ongoing epidemiological transition in sub-Saharan Africa (SSA), conditions that require invasive treatment (surgery, cancer, and anaesthesia, etc.) will become increasingly common. Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process aimed at identifying older people at risk of negative outcomes. It is important to know whether this approach integrates care management strategies for older people in a context where health services for older people are scarce, and staff members have little training in geriatrics. The current work is a situational analysis on the use of CGA on invasive care (cancer, surgery, etc.) among older people in SSA. Methods: We searched PubMed-MEDLINE and other sources for studies reporting on CGA and conditions requiring invasive treatment in older patients in SSA. Results/Conclusions: We found no study that had comprehensively examined CGA and invasive care in SSA. There is, however, evidence that the offer of invasive care to older people has improved in SSA. Further research is needed to explore the applicability of CGA in SSA. Similarly, more investigations are needed on the role of CGA in the care trajectories of older people in SSA, in terms of outcomes and affordability. Full article
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