School of Nursing and Midwifery, College of Medicine and Health, University College Cork, College Road, Cork T12 AK54, Ireland.
School of Allied Health, University of Limerick, Limerick V94 T9PX, Ireland.
Age Ageing. 2023 Nov 2;52(11). doi: 10.1093/ageing/afad210.
Comprehensive geriatric assessment (CGA) is the cornerstone of modern geriatric medicine and the framework around which conventional and new models of care for older people are developed. Whilst there are a substantial number of reviews synthesising the evidence on patient and service outcomes from CGA, as an intervention it remains poorly described. There is a lack of detail on how a CGA plan is coordinated, delivered and followed up, especially outside of acute care. This commentary reflects on the authors' experience of extracting data from 57 published studies on CGA. CGA as an intervention is akin to a 'black box' in terms of describing and measuring participants' interactions with CGA activity in terms of time, frequency and amount (dose) received. There is also a lack of detail on how newly established CGA teams become effective, interdisciplinary, high functioning and sustainable teams. The CGA knowledge-do gap persists with a need to draw from complex system theory and implementation science frameworks to better describe the intervention and understand the influence of the organisation and health service within which CGA is operationalised. Equally, the voice of older people, families and staff is critical in the conduct and evaluation of CGA, and how it evolves as a model to meet the growing needs of ageing populations.
全面老年评估（CGA）是现代老年医学的基石，也是制定传统和新型老年人护理模式的框架。虽然有大量的综述综合了 CGA 对患者和服务结果的证据，但作为一种干预措施，它的描述仍然很差。缺乏关于如何协调、提供和跟进 CGA 计划的细节，特别是在急性护理之外。本文评论反映了作者从 57 项关于 CGA 的已发表研究中提取数据的经验。就描述和衡量参与者与 CGA 活动的互动时间、频率和数量（剂量）而言，CGA 作为一种干预措施类似于一个“黑箱”。此外，关于新成立的 CGA 团队如何变得高效、跨学科、高功能和可持续的团队，也缺乏细节。CGA 的知识差距仍然存在，需要借鉴复杂系统理论和实施科学框架，以更好地描述干预措施，并了解组织和卫生服务在其中运作的影响。同样，老年人、家庭和工作人员的声音对于 CGA 的实施和评估至关重要，以及它如何作为一种满足人口老龄化日益增长需求的模式而发展。
