Arnautovska Urska, Soole Rebecca, Wing Ling Kwan Winona, Reid Natasha, Baker Andrea, Gordon Emily H, Hubbard Ruth E, Siskind Dan, Warren Nicola
Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.
Metro South Addiction and Mental Health Services, Woolloongabba, QLD, Australia.
BMC Psychiatry. 2025 May 12;25(1):473. doi: 10.1186/s12888-025-06830-3.
Individuals with severe mental illness (SMI) are at risk of early-onset frailty, leading to adverse outcomes. Effective interventions for reducing frailty in this population are currently lacking.
To assess the feasibility, acceptability, and preliminary efficacy of Comprehensive Geriatric Assessment (CGA), delivered by an Advanced Trainee in Geriatric Medicine, as an intervention for individuals with co-occurring frailty and SMI.
Participants, aged 18-64, with frailty and SMI were recruited from public community outpatient clinics between July 2022 and January 2023. Feasibility of CGA was evaluated through mixed methods. Secondary outcomes included a range of mental and physical health factors.
Out of 38 eligible individuals, 17 were enrolled and 14 completed the study; three dropped out post-baseline assessment and CGA. 86% were male, average age was 48.4, Body Mass Index 34.6, and Frailty Index 0.35. Participants expressed high acceptability and perceived benefits of CGA, including increased insight about one's health and receipt of multidisciplinary holistic care. While this study was inadequately powered to show statistically significant changes in secondary outcomes, positive trends were observed in overall psychosis symptoms and weekly physical activity engagement which increased by 56.6 min, reaching the recommended levels to achieve health benefits.
The findings of this study support the feasibility of CGA as an intervention in routine care of people with SMI and provide evidence for designing future trials of frailty interventions in this population. The study underscores the significance of tailored, multidisciplinary, and individualised approaches, though further research is required to substantiate its efficacy in this priority population.
患有严重精神疾病（SMI）的个体有早发性衰弱的风险，会导致不良后果。目前缺乏有效降低该人群衰弱程度的干预措施。
评估由老年医学高级受训人员提供的综合老年评估（CGA）作为一种针对同时患有衰弱和严重精神疾病个体的干预措施的可行性、可接受性和初步疗效。
2022年7月至2023年1月期间，从公共社区门诊招募了年龄在18 - 64岁、患有衰弱和严重精神疾病的参与者。通过混合方法评估CGA的可行性。次要结果包括一系列心理和身体健康因素。
在38名符合条件的个体中，17名被纳入研究，14名完成了研究；3名在基线评估和CGA后退出。86%为男性，平均年龄48.4岁，体重指数34.6，衰弱指数0.35。参与者对CGA表现出高度的可接受性，并认为其有益处，包括对自身健康有更多了解以及接受多学科整体护理。虽然本研究的样本量不足以显示次要结果有统计学上的显著变化，但在总体精神病症状和每周身体活动参与方面观察到了积极趋势，身体活动增加了56.6分钟，达到了获得健康益处的推荐水平。
本研究结果支持CGA作为严重精神疾病患者常规护理干预措施的可行性，并为设计该人群未来的衰弱干预试验提供了证据。该研究强调了量身定制、多学科和个体化方法的重要性，不过需要进一步研究来证实其在这一重点人群中的疗效。
