Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan.
Department of Nursing, Yasuda Women's University, 6-13-1, Yasu Higashi, Asaminami-Ku, Hiroshima, Hiroshima, 731-0531, Japan.
BMC Geriatr. 2024 Aug 1;24(1):645. doi: 10.1186/s12877-024-05200-0.
Frailty has become a key concern in an aging population. A comprehensive geriatric assessment (CGA) service framework was developed and evaluated aiming to target and connect frail older adults who are at high risk of requiring long-term care services.
A community-based pilot study was conducted in fiscal year 2016 and 2017 in Kure city, Hiroshima, Japan. Participants aged 65 and over living in Kure city, and 393 persons were extracted from the Kihon Check List (KCL) responses. Among the eligible individuals, 101 consented to participate and received CGA and referred to services based on individual health needs. The efficacy was evaluated by referral rate of services, continuity of the service usage, evaluation of participant's health condition and the quality of life (QoL) after the 6-month follow-up.
Ninety-nine (98.0%) participants needed support for the instrumental activity of daily living, 97 (96.0%) were categorized as locomotive syndrome, and 64 (63.4%) had a depressive tendency. Afterward, 60 participants (59.4%) subsequently accepted the referral services, however, 34 (33.7%) used the services and the remaining 26 (25.7%) did not use the services. The health condition improvements in the service-uses group were statistically significant (p < 0.001), however, QoL score did not change between the baseline and 6th -month.
KCL extracted high-risks older people, and CGA revealed related diseases and health conditions. However, the high refusal rate of referral services indicates a necessity to modify the service framework such as by collaborating with community general support centers, which could increase the efficacy of service framework.
衰弱已成为人口老龄化的一个关键问题。本研究旨在建立并评估一种全面的老年评估（CGA）服务框架，以识别和联系有潜在长期护理需求的体弱老年人。
本研究是一项于 2016 年至 2017 年在日本广岛县吴市开展的社区试点研究。参与者为居住在吴市且年龄在 65 岁及以上的人群，从基本健康检查表（KCL）的回答中提取了 393 人。在符合条件的个体中，有 101 人同意参与并接受了 CGA，并根据个人健康需求被转介至相应服务。通过服务转介率、服务使用的连续性、参与者健康状况评估以及 6 个月随访后的生活质量（QoL）来评估其效果。
99 名（98.0%）参与者需要辅助日常生活活动，97 名（96.0%）参与者被归类为运动障碍综合征，64 名（63.4%）参与者有抑郁倾向。随后，有 60 名（59.4%）参与者接受了转介服务，但仅有 34 名（33.7%）实际使用了服务，其余 26 名（25.7%）未使用服务。使用服务组的健康状况改善具有统计学意义（p < 0.001），但在基线和 6 个月时 QoL 评分没有变化。
KCL 可提取高风险老年人，CGA 可揭示相关疾病和健康状况。然而，转介服务的高拒绝率表明需要对服务框架进行修改，例如与社区综合支持中心合作，这可能会提高服务框架的效果。
