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Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment
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Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 25 July 2024 | Viewed by 5570

Special Issue Editors

Dr. Nicola Veronese

E-Mail Website
Guest Editor
Department DI.PE.CA, Geriatric Unit, University Hospital AOUP, University of Palermo, Palermo, Italy
Interests: osteoarthritis; frailty; sarcopenia; osteoporosis; comprehensive geriatric assessment; nutritional issues
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Alberto Pilotto

E-Mail Website
Guest Editor
1. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy
2. Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
Interests: geriatric care; comprehensive geriatric assessment; multidimensional prognostic index; gerontechnology; gastroenterology

Special Issue Information

Dear Colleagues,

Recently there has been extensive literature that suggested that frailty should be identified using a multidimensional approach, a novel approach that permits to better understand the needs of older people. For example, the prevalence of frailty and pre-frailty in older populations, using the multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment (CGA) are extremely high, particularly in some settings, such as nursing homes and hospitals. Moreover, a multidimensional approach could be useful in identifying the pathophysiological mechanisms of clinical frailty useful to understand the trajectory from healthy aging to frailty, including the role of the individual response to chronic diseases that seems to be associated with clinical frailty. 

In this Special Issue, we invite authors to submit works regarding the importance and use of CGA in older people for a better understanding of frailty from a multidimensional point of view, including the functional and psychosocial, as well as the biological and genetic factors related to clinical frailty. Both reviews (narrative or systematic) and original works (also in terms of intervention studies) are welcome for this Special Issue.

Dr. Nicola Veronese
Prof. Dr. Alberto Pilotto
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • frailty
  • multidimensional
  • comprehensive geriatric assessment
  • multidimensional prognostic index
  • prognosis
  • older people

Published Papers (4 papers)

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Research

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13 pages, 1225 KiB  
Article
A Prospective Observational Study of Frailty in Geriatric Revitalization Aimed at Community-Dwelling Elderly
by Almudena Morales-Sánchez, José Ignacio Calvo Arenillas, María José Gutiérrez Palmero, José L. Martín-Conty, Begoña Polonio-López, Luís Alonso Dzul López, Laura Mordillo-Mateos, Juan José Bernal-Jiménez, Rosa Conty-Serrano, Francisca Torres-Falguera, Alfonso Martínez Cano and Carlos Durantez-Fernández
J. Clin. Med. 2024, 13(9), 2514; https://doi.org/10.3390/jcm13092514 - 25 Apr 2024
Viewed by 238
Abstract
(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent [...] Read more.
(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45–50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed “Up & Go” at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods. Full article
(This article belongs to the Special Issue Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment)
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11 pages, 1321 KiB  
Article
Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project
by Wanda Morganti, Nicola Veronese, Marina Barbagelata, Alberto Castagna, Carlo Custodero, Luisa Solimando, Marianna Ilarj Burgio, Sofia Elena Montana Lampo, Emanuele Seminerio, Gianluca Puleo, Barbara Senesi, Lisa Cammalleri, Giovanni Ruotolo, Carlo Sabbà, Mario Barbagallo and Alberto Pilotto
J. Clin. Med. 2023, 12(18), 6026; https://doi.org/10.3390/jcm12186026 - 18 Sep 2023
Viewed by 2759
Abstract
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed [...] Read more.
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland–Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people. Full article
(This article belongs to the Special Issue Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment)
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20 pages, 1950 KiB  
Article
Comprehensive Geriatric Assessment and Quality of Life Aspects in Patients with Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC)
by Anna Winter, Stefan M. Schulz, Marc Schmitter, Urs Müller-Richter, Alexander Kübler, Sylvia Kasper and Stefan Hartmann
J. Clin. Med. 2023, 12(17), 5738; https://doi.org/10.3390/jcm12175738 - 03 Sep 2023
Cited by 2 | Viewed by 1025
Abstract
To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric [...] Read more.
To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric assessment (CGA) was performed on 21 r/m HNSCC patients at two defined assessments, and the QoL aspects and the impact of descriptive data were evaluated. The Kolmogorov–Smirnov test, Spearman’s rho correlation, and two-way mixed ANOVA were used for statistical analysis. All patients were found to be “frail”. Pain, fatigue, and the burden of illness were the highest-rated symptoms. Oral function and orofacial appearance were highly impaired. A significant impact of descriptive data on the CGA and QoL results was found (all p ≤ 0.05). Thus, the CGA results revealed high frailty, severe comorbidities, and high impairments in QoL aspects. The CGA and QoL results were negatively affected by the primary HNSCC treatment approach, the need for prosthetic treatment, and worse oral functional capacity. Therefore, frailty in r/m HNSCC patients seems to be multidimensional. The evaluation of the CGA and QoL aspects in r/m HNSCC patients can be recommended to detect special needs, organize aftercare, and improve the support for frail and vulnerable cancer patients to create a multidisciplinary treatment approach. Full article
(This article belongs to the Special Issue Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment)
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Review

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11 pages, 271 KiB  
Review
Pre-Therapeutic Assessment of Older People in Sub-Saharan Africa: Introduction to the Comprehensive Geriatric Assessment
by Marie-Josiane Ntsama Essomba, Berthe Sabine Esson Mapoko, Junette Arlette Metogo Mbengono, Nadine Simo-Tabue, Andre Pascal Kengne, Simeon Pierre Choukem, Eugène Sobngwi, Jacqueline Ze Minkande and Maturin Tabue Teguo
J. Clin. Med. 2024, 13(6), 1801; https://doi.org/10.3390/jcm13061801 - 21 Mar 2024
Viewed by 963
Abstract
Objectives: With the ongoing epidemiological transition in sub-Saharan Africa (SSA), conditions that require invasive treatment (surgery, cancer, and anaesthesia, etc.) will become increasingly common. Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process aimed at identifying older people at risk of negative [...] Read more.
Objectives: With the ongoing epidemiological transition in sub-Saharan Africa (SSA), conditions that require invasive treatment (surgery, cancer, and anaesthesia, etc.) will become increasingly common. Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process aimed at identifying older people at risk of negative outcomes. It is important to know whether this approach integrates care management strategies for older people in a context where health services for older people are scarce, and staff members have little training in geriatrics. The current work is a situational analysis on the use of CGA on invasive care (cancer, surgery, etc.) among older people in SSA. Methods: We searched PubMed-MEDLINE and other sources for studies reporting on CGA and conditions requiring invasive treatment in older patients in SSA. Results/Conclusions: We found no study that had comprehensively examined CGA and invasive care in SSA. There is, however, evidence that the offer of invasive care to older people has improved in SSA. Further research is needed to explore the applicability of CGA in SSA. Similarly, more investigations are needed on the role of CGA in the care trajectories of older people in SSA, in terms of outcomes and affordability. Full article
(This article belongs to the Special Issue Multidimensional Frailty: The Role of Comprehensive Geriatric Assessment)
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