Impact of geriatric syndrome burden on healthcare services utilization and mortality among community-dwelling older adults: is it still too late to do something?

IF 3.5 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Bilal Katipoglu, Suleyman Emre Kocyigit
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引用次数: 0

Abstract

Purpose: The increasing longevity of the population emphasizes the need for a deeper understanding of geriatric syndromes and their implications for healthcare usage and mortality among older adults. This study aimed to identify risk factors associated with healthcare service utilization and mortality of community-dwelling adults aged 80 and older in YASAM project.

Methods: This prospective cohort study was part of the HEAT-YASAM trial, which focused on the community-based integrated healthy aging program for individuals aged 80 years and older in Balıkesir, Türkiye. The burden of geriatric syndromes was assessed based on a comprehensive evaluation at least two domains of the nutrition, cognitive, physcological and locomotor capacities. The study outcome was healthcare services utilization (inpatient, outpatient, emergency admission) and all-cause mortality data obtained during follow-up period (9 months).

Results: The cohort consisted of 5018 participants with a mean age of 85.8 years, predominantly female (53.1%). On the multivariable analysis, geriatric syndrome burden and Deyo Charlson Comorbidity index (D-CCI) score significant on independent predictors of 9-month mortality (p = 0.01). Higher geriatric syndrome burden was linked to an approximately 10% lower risk for outpatient admissions (p = 0.01) and every point increase in the D-CCI score was associated with a 1.3-fold increased risk of utilizing outpatient services (p = 0.01). For multimorbidity, every point increase corresponded to a 2.6-fold higher risk of inpatient admissions (p = 0.01) and a 1.2-fold higher risk of emergency admissions (p = 0.01).

Conclusions: This study demonstrate that a geriatric syndrome burden and multimorbidity has a significant impact on healthcare utilization and mortality in adults aged 80 years and older. Integrated comprehensive, coordinated, and patient-centered care models for this population facing multiple geriatric syndromes could positively impact the healthcare system.

Trial registration: The trial was prospectively registered at ClinicalTrials.gov. Identifier: NCT05993572 Registered on 15 July 2023.

老年综合征负担对社区居住老年人卫生保健服务利用和死亡率的影响:现在采取行动是否为时已晚?
目的:人口寿命的延长强调需要更深入地了解老年综合征及其对老年人医疗保健使用和死亡率的影响。本研究旨在找出与YASAM项目中80岁及以上社区居民的医疗保健服务利用和死亡率相关的危险因素。方法:这项前瞻性队列研究是HEAT-YASAM试验的一部分,该试验的重点是针对Balıkesir、 rkiye地区80岁及以上老年人的社区综合健康老龄化计划。老年综合征的负担是根据营养、认知、生理和运动能力至少两个领域的综合评估来评估的。研究结果是在随访期间(9个月)获得的医疗服务利用(住院、门诊、急诊入院)和全因死亡率数据。结果:该队列包括5018名参与者,平均年龄85.8岁,以女性为主(53.1%)。在多变量分析中,老年综合征负担和Deyo Charlson合并症指数(D-CCI)评分对9个月死亡率的独立预测因子有显著性意义(p = 0.01)。较高的老年综合征负担与门诊入院风险降低约10%相关(p = 0.01), D-CCI评分每增加1分,门诊就诊风险增加1.3倍相关(p = 0.01)。对于多重疾病,每增加1分,住院风险增加2.6倍(p = 0.01),急诊入院风险增加1.2倍(p = 0.01)。结论:老年综合征负担和多病对80岁及以上老年人的医疗保健利用和死亡率有显著影响。综合全面,协调,以患者为中心的护理模式,这一人口面临多种老年综合征可以积极影响医疗保健系统。试验注册:该试验在ClinicalTrials.gov上进行了前瞻性注册。标识符:NCT05993572注册于2023年7月15日。
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来源期刊
European Geriatric Medicine
European Geriatric Medicine GERIATRICS & GERONTOLOGY-
CiteScore
6.70
自引率
2.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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