Dr. Tzyy-Guey Tseng, No.100, Shin-Chuan 1st Road, Sanmin Dist., Kaohsiung City 80708, Taiwan (R.O.C.), Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Email:
J Nutr Health Aging. 2021;25(1):134-140. doi: 10.1007/s12603-020-1456-7.
The study aimed to develop a brief geriatric assessment (BGA) tool for the general practitioner to evaluate geriatric syndromes in community-dwelling older adults.
A cross-sectional study.
58 communities from four aging cities in Taiwan.
1,258 community-dwelling older adults aged 65 years and above.
The BGA targeted physical function impairment, cognitive impairment, and mood impairment. The cutoff values of physical function tests (handgrip strength and 6-meter walk test [6MWT]) were estimated by receiver operating characteristic analysis. Second, the diagnostic validity of the BGA was calculated in terms of sensitivity, specificity, and predictive values, which were compared to corresponding comprehensive geriatric assessment (CGA) items. Third, the associated risk factors of geriatric syndromes were selected using stepwise logistic regression. Finally, we combined items selected from literature and CGA and then proposed a practical BGA framework.
The proposed BGA comprised dominant handgrip strength, 6MWT, self-report personal birthday, address, and telephone number, question 'Do you have depressive mood for the past two weeks?', Rinne tuning-fork tests, Snellen scale, and body mass index. It evaluated multidimensional aspects of geriatrics syndromes including physical, cognitive, mood, and sensory impairment, sarcopenia, and nutrition status. Sensitivities in the Taiwan BGA items ranged from 48% for dominant handgrip strength to 97.6% for 6MWT corresponding to physical impairment; 58.3% for cognitive impairment corresponding to Short Portable Mental Status Questionnaire; 62.7% for mood impairment corresponding to Geriatric Depression Scale. The Taiwan BGA for the general practitioner takes less than 10 minutes and is suitable in the community setting.
Early management of geriatric syndromes in the community is important. The current study demonstrated a practical BGA tool for the general practitioner to comprehensively assess geriatric syndromes in community-dwelling older adults.
本研究旨在为全科医生开发一种简易老年评估（BGA）工具，以评估社区居住的老年人的老年综合征。
横断面研究。
台湾四个老龄化城市的 58 个社区。
1258 名 65 岁及以上的社区居住老年人。
BGA 针对身体功能障碍、认知障碍和情绪障碍。通过受试者工作特征分析估计身体功能测试（握力和 6 米步行测试[6MWT]）的截断值。其次，根据敏感性、特异性和预测值计算 BGA 的诊断准确性，并与相应的全面老年评估（CGA）项目进行比较。第三，使用逐步逻辑回归选择老年综合征的相关危险因素。最后，我们结合文献和 CGA 中选择的项目，提出了一个实用的 BGA 框架。
提出的 BGA 包括优势手握力、6MWT、自我报告个人生日、地址和电话号码、问题“过去两周你是否有抑郁情绪？”、Rinne 音叉测试、Snellen 视力表和体重指数。它评估了老年综合征的多个维度，包括身体、认知、情绪和感觉障碍、肌肉减少症和营养状况。台湾 BGA 项目的敏感性范围为优势手握力的 48%至 6MWT 的 97.6%，对应于身体功能障碍；认知障碍的短便携精神状态问卷为 58.3%；对应于老年抑郁量表的情绪障碍为 62.7%。台湾的全科医生 BGA 不到 10 分钟即可完成，适用于社区环境。
早期管理社区老年综合征非常重要。本研究为全科医生提供了一种实用的 BGA 工具，用于全面评估社区居住的老年人的老年综合征。
