title: Comprehensive geriatric assessment for older adults admitted to hospital.
abstract: BACKGROUND
  Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up.
  
  
  OBJECTIVE
  We sought to evaluate the effectiveness of CGA in hospital for older adults admitted as an emergency.
  
  
  METHODS
  We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), the Database of Abstracts of Reviews of Effects (DARE), MEDLINE, EMBASE, CINAHL and AARP Ageline, and handsearched high-yield journals.
  
  
  METHODS
  We searched for randomised controlled trials comparing CGA (whether by mobile teams or in designated wards) to usual care.
  
  
  METHODS
  Two review authors initially assessed eligibility and trial quality and extracted published data.
  
  
  RESULTS
  Twenty-two trials evaluating 10,315 participants in six countries were identified. Patients in receipt of CGA were more likely to be alive and in their own homes at up to six months (OR 1.25, 95% CI 1.11 to 1.42, P = 0.0002) and at the end of scheduled follow up (median 12 months) (OR 1.16, 95% CI 1.05 to 1.28, P = 0.003) when compared to general medical care. In addition, patients were less likely to be institutionalised (OR 0.79, 95% CI 0.69 to 0.88, P < 0.0001). They were less likely to suffer death or deterioration (OR 0.76, 95% CI 0.64 to 0.90, P = 0.001), and were more likely to experience improved cognition in the CGA group (OR 1.11, 95% CI 0.20 to 2.01, P = 0.02). Subgroup interaction in the primary outcomes suggests that the effects of CGA are primarily the result of CGA wards.
  
  
  CONCLUSIONS
  Comprehensive geriatric assessment increases a patient's likelihood of being alive and in their own home at up to 12 months.
authors: Medicine for the Elderly, Monklands Hospital, Monkscourt Avenue, Airdrie, Scotland, UK, ML6 0JS.
authors: Graham
authors: G
authors: Ellis
authors: Martin A
authors: MA
authors: Whitehead
authors: Desmond
authors: D
authors: O'Neill
authors: Peter
authors: P
authors: Langhorne
authors: David
authors: D
authors: Robinson
mesh_terms: D000368:Aged; D003191:Comprehensive Health Care / Q000379:methods*; D004630:Emergencies; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D057187:Independent Living; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care