Veronese Nicola, Fazzari Anna, Santangelo Eleonora, Iommi Candela, Soysal Pinar, Custodero Carlo, Pickert Lena, Polidori Maria Cristina, Stolniceanu Nicoleta, Michalkova Helena, Topinkova Eva, Pilotto Alberto, Barbagallo Mario
Unit of Geriatrics, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Faculty of Medicine, Saint Camillus International University of Health Sciences, Rome, Italy.
Aging Clin Exp Res. 2025 May 16;37(1):155. doi: 10.1007/s40520-025-03061-0.
OBJECTIVES: This study aimed to assess the effectiveness of Comprehensive Geriatric Assessment (CGA) compared to standard of care in improving pain, physical function, and stiffness in older adults with knee osteoarthritis (OA) over six months. Secondary outcomes included multidimensional frailty and quality of life. DESIGN: An exploratory, multicentre, randomized controlled trial (RCT). SETTING: Five European geriatric centres in Italy, Germany, Turkiye and the Czech Republic. PARTICIPANTS: Seventy older adults (mean age 76.1 ± 6.8 years; 80% female) with knee OA (Kellgren-Lawrence Grades 1-2) were randomized into two groups: CGA (n = 35) or standard of care (n = 35). INTERVENTION: The CGA group underwent a multidimensional geriatric assessment and intervention, identifying impairments and tailoring interventions accordingly, while the control group received standard of care. MAIN OUTCOME MEASURES: The primary endpoint was improvement in pain, stiffness, and functional limitations measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) over six months. Secondary outcomes included changes in multidimensional frailty (Multidimensional Prognostic Index, MPI), quality of life (SF-36), and adherence to interventions. RESULTS: The CGA group showed a non-significant improvement in total WOMAC scores (-4.49 ± 3.40, p = 0.19), with slight reductions in pain (-1.12 ± 0.96) and functional limitations (-3.26 ± 2.21). MPI slightly improved (-0.02 ± 0.04, p = 0.69), but no significant changes were observed in SF-36 scores. No falls, hospitalizations, or severe adverse events were reported. CONCLUSIONS: CGA may offer potential benefits for managing knee OA in older adults, particularly for pain and function, though statistical significance was not achieved. Larger studies with longer follow-up are warranted to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05659979.
目的：本研究旨在评估综合老年评估（CGA）与标准治疗相比，在改善老年膝骨关节炎（OA）患者疼痛、身体功能和僵硬程度方面的效果，为期六个月。次要结局包括多维衰弱和生活质量。 设计：一项探索性、多中心、随机对照试验（RCT）。 地点：意大利、德国、土耳其和捷克共和国的五个欧洲老年医学中心。 参与者：70名老年膝骨关节炎患者（平均年龄76.1±6.8岁；80%为女性，Kellgren-Lawrence分级为1-2级）被随机分为两组：CGA组（n = 35）和标准治疗组（n = 35）。 干预措施：CGA组接受多维老年评估和干预，识别损伤并相应调整干预措施，而对照组接受标准治疗。 主要结局指标：主要终点是使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）在六个月内测量的疼痛、僵硬和功能受限的改善情况。次要结局包括多维衰弱（多维预后指数，MPI）、生活质量（SF-36）的变化以及对干预措施的依从性。 结果：CGA组WOMAC总分有非显著改善（-4.49±3.40，p = 0.19），疼痛（-1.12±0.96）和功能受限（-3.26±2.21）略有降低。MPI略有改善（-0.02±0.04，p = 0.69），但SF-36评分未观察到显著变化。未报告跌倒、住院或严重不良事件。 结论：CGA可能对老年膝骨关节炎的管理有潜在益处，特别是在疼痛和功能方面，尽管未达到统计学显著性。需要进行更大规模、更长随访期的研究来证实这些发现。 试验注册：ClinicalTrials.gov标识符：NCT05659979。
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