[Geriatric Assessment in the Hospital - An Overview of Clinical Guidelines].

Abstract

According to forecasts, 27 % of the German population will be aged 65 or over by 2050. Age-associated multimorbidity, functional impairment and need for care have a considerable impact on the healthcare system. A comprehensive geriatric assessment (CGA) is therefore essential to identify health risks at an early stage and make targeted treatment decisions. Numerous studies prove effectiveness of CGA regarding relevant clinical outcomes. In Germany, an S3 guideline with recommendations on CGA in hospitalised patients was published in 2024. There is also an S1 guideline with recommendations on assessment tools. Internationally, the UK, the Netherlands and Italy have published corresponding recommendations. In oncology, two guidelines recommend the systematic integration of CGA before starting cancer treatment. Guidelines emphasise the multidimensional and interprofessional implementation of CGA using standardised, validated instruments. In acute geriatrics, CGA has established as an integral part of care. Focussed screening is recommended in the emergency department. Orthogeriatric co-management has been shown to be associated with lower mortality and improved treatment outcomes. In oncology, CGA is becoming increasingly important for customising treatment. Prognostic tools such as the multidimensional prognostic index (MPI) enable targeted risk stratification. The implementation of CGA is hampered by limited time resources, staff shortages and inconsistent billing modalities. Clear recommendations on the selection of suitable assessment tools could improve utilisation and integration in the future. New technologies such as artificial intelligence and digital applications offer promising approaches for increasing efficiency. The development of a European guideline could help to establish CGA in various care structures.