Modifiable Geriatric Risk Factors Identified by CGA Predict Adverse Outcomes in Frail Vietnamese Older Adults: A 12-Month Longitudinal Study

Abstract

Introduction

Vietnam's rapidly aging population faces a growing burden of frailty. Comprehensive geriatric assessment (CGA) is a key tool for identifying modifiable risk factors like malnutrition and physical inactivity, but prospective evidence of its predictive utility in Vietnam is lacking. This evidence gap hinders the integration of targeted, person-centered interventions into routine clinical practice to improve health outcomes for this vulnerable population.

Objective

To prospectively evaluate associations between geriatric syndromes identified by baseline CGA and 12-month adverse outcomes, including hospitalization and falls, among frail older adults in Vietnam.

Methods

This 12-month longitudinal study included 280 frail older adults (aged ≥60 years) identified via Fried's phenotype criteria. A baseline CGA assessed multiple geriatric syndromes. Associations with 12-month outcomes were examined using multilevel logistic regression, adjusted for sociodemographic covariates.

Results

Significant predictors of increased hospitalization included multimorbidity (OR = 2.17), dependency in activities of daily living (ADL) (OR = 1.80), and malnutrition (OR = 1.70). A high baseline fall-risk index strongly predicted subsequent fall incidence (OR = 1.84). Unexpectedly, hearing impairment was associated with a lower likelihood of falls (OR = 0.46), and depression was linked to a reduced odds of recurrent falls (OR = 0.40).

Conclusion

CGA is a valuable predictive tool for identifying high-risk older adults in Vietnam. Key modifiable risk factors (multimorbidity, functional dependency, malnutrition, and depression) are strong predictors of adverse outcomes and represent priority targets for lifestyle-based non-pharmacological interventions. Integrating CGA into routine care can guide proactive strategies to mitigate adverse outcomes and improve quality of life.