[Randomized clinical trial on the efficacy of global geriatric assessment in primary care].
OBJECTIVE
the family doctor is in a unique position to prevent complications in the elderly population. The aim of this study was to evaluate the efficacy of a multifactorial intervention in reducing morbidity and mortality after a global geriatric assessment (GGA) was performed.


METHODS
a randomized clinical trial with a control group was carried out in elderly patients aged more than 75 years old visited in the primary care setting over a 18-month period. An individualized intervention was applied to all patients in the intervention group (IG) identified as frail by the GGA. A group session was offered to the remaining patients in the IG.


RESULTS
there were 620 participants: 49.7% were randomized to the IG and 50.3% to the control group (CG). Follow-up was completed by 430 (69.4%) participants. At the end of the study, the CG showed a significantly greater risk of depression (Yesavage) than the IG (P=.048). During the follow-up, 13% of the IG and 5% of the CG changed their initial status of frailty to one of non-frailty, while 11% of the IG and 22% of the CG were newly diagnosed as frail (P< .001). The total number of events (nursing home admission, home visits, deaths) was 15% in the IG and 17% in the CG (P=.64).


CONCLUSIONS
the intervention proved to be effective in containing the number of patients newly diagnosed as frail and in increasing the number of participants who reversed their status from frail to non-frail during the follow-up. GGA is effective if used in conjunction with an intervention.
Monteserín Nadal
Rosa
R
Equipo de Atención Primaria Sardenya, Barcelona, España. rmonteserin@eapsardenya.cat
Altimir Losada
Salvador
S
Brotons Cuixart
Carlos
C
Padrós Selma
Jaume
J
Santaeugenia González
Sebastián
S
Moral Peláez
Irene
I
Fornasini
Marco
M
Sellarès Sallas
Jaume
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D011320:Primary Health Care