Comprehensive geriatric assessment: a meta-analysis of controlled trials.
There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls. Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1.68 (1.17-2.41) for geriatric evaluation and management units, 1.49 (1.12-1.98) for hospital-home assessment services, and 1.20 (1.05-1.37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons.
Stuck
A E
AE
Department of Geriatrics and Rehabilitation, Bern, Switzerland.
Siu
A L
AL
Wieland
G D
GD
Adams
J
J
Rubenstein
L Z
LZ
D000203:Activities of Daily Living; D000359:Aftercare; D000368:Aged; D002986:Clinical Trials as Topic; D003071:Cognition; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005853:Geriatrics; D006699:Home Care Services; D006757:Hospital Units; D006801:Humans; D009026:Mortality; D010343:Patient Admission; D010359:Patient Readmission; D012017:Referral and Consultation