Tomita Naoki, Ohashi Yuki, Ishiki Aiko, Ozaki Akiko, Nakao Mitsuyuki, Ebihara Satoru, Taki Yasuyuki
Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai 980-8575, Miyagi, Japan.
Department of Aging Research and Geriatric Medicine, Division of Brain Science, Institute of Development, Aging, and Cancer (IDAC), Tohoku University, Sendai 980-8575, Miyagi, Japan.
J Clin Med. 2023 Jul 26;12(15):4917. doi: 10.3390/jcm12154917.
Multidimensional assessments are important in evaluating the overall health of older adults. The comprehensive geriatric assessment (CGA) is a representative framework; however, the burden associated with the CGA has led to the development of simplified multidimensional tools. Comparing these tools to the CGA can help utilize them effectively. However, a direct comparison is challenging owing to the conceptual nature of the CGA. In this study, we conducted a web-based survey to identify essential CGA components by linking International Classification of Functioning, Disability, and Health (ICF) category level 2 items and "not defined/not covered" (nd/nc) items. Healthcare professionals and individuals aged >65 years participated in a two-stage Delphi study. In total, 182 respondents (7 geriatricians, 22 nurses, 20 therapists, and 4 case managers) completed the survey. Sixty-one essential components for CGA were identified, including 55 ICF categories. Additionally, personal factors (i.e., proactiveness) and nd/nc items (i.e., subjective perceptions) were aggregated. The results suggest that the CGA includes objective conditions of intrinsic capacity, functional ability, and environment as well as subjective perceptions and proactiveness toward those conditions. Thus, CGA is not merely expected to assess geriatric syndrome but also to estimate broader concepts, such as interoception, resilience, and quality of life.
多维评估对于评估老年人的整体健康状况很重要。综合老年评估(CGA)是一个具有代表性的框架;然而,与CGA相关的负担促使了简化的多维工具的发展。将这些工具与CGA进行比较有助于有效利用它们。然而,由于CGA的概念性质,直接比较具有挑战性。在本研究中,我们通过将国际功能、残疾和健康分类(ICF)第2类项目与“未定义/未涵盖”(nd/nc)项目相联系,开展了一项基于网络的调查,以确定CGA的基本组成部分。医疗保健专业人员和65岁以上的个人参与了一项两阶段的德尔菲研究。共有182名受访者(7名老年病医生、22名护士、20名治疗师和4名病例管理人员)完成了调查。确定了61个CGA的基本组成部分,包括55个ICF类别。此外,还汇总了个人因素(即积极性)和nd/nc项目(即主观感受)。结果表明,CGA包括内在能力、功能能力和环境的客观状况,以及对这些状况的主观感受和积极性。因此,CGA不仅有望评估老年综合征,还能估计更广泛的概念,如内感受、恢复力和生活质量。