title: The effectiveness of a comprehensive geriatric assessment intervention program for frailty in community-dwelling older people: a randomized, controlled trial.
abstract: This randomized, controlled trial assessed the effectiveness of comprehensive geriatric assessment (CGA) and subsequent intervention in pre-frail and frail community-dwelling elderly based on the Fried Frailty Criteria (FFC) and the Barthel Index (BI) A total of 310 pre-frail or frail elderly from a single community were identified using the FFC. Of these, 152 were randomly assigned to the intervention group for CGA and appropriate intervention by medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and specialty referral. Clinical outcome was re-evaluated by the FFC and BI 6 months later. Compared to the control group, the intervention group tended to have a better outcome, with an odds ratio (OR) = 1.19, 95% confidence interval (95% CI) = 0.48-3.04, p = 0.71) and 3.29 (95% CI = 0.65-16.64, p = 0.15), respectively, and were less likely to deteriorate, with an OR = 0.78 (95% CI = 0.34-1.79, p = 0.57) and 0.94 (95% CI = 0.42-2.12, p = 0.88), respectively. Although no significant differences were observed, the CGA and subsequent intervention showed a favorable outcome in frail and pre-frail elderly based on the frailty status and BI. Inability to complete the CGA and poor compliance with the intervention program appear to be the main reasons for unfavorable outcomes.
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch Hospital. No. 37 Kangding Rd., Taipei City, Taiwan.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Li
authors.forename: Chin-Ying
authors.initials: CY
authors.lastname: Chen
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Li
authors.forename: Wei-Dean
authors.initials: WD
authors.lastname: Wang
authors.forename: Shwu-Chong
authors.initials: SC
authors.lastname: Wu
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008297:Male; D009752:Nutritional Status; D026741:Physical Therapy Modalities; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation; D012944:Social Support; D013624:Taiwan