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. 2024 May 27;36(1):121.
doi: 10.1007/s40520-024-02772-0.

The Italian guideline on comprehensive geriatric assessment (CGA) for the older persons: a collaborative work of 25 Italian Scientific Societies and the National Institute of Health

Alberto Pilotto  1   2 , Pierangelo Lora Aprile  3 , Nicola Veronese  4 , Eleonora Lacorte  5 , Wanda Morganti  1 , Carlo Custodero  2 , Paola Piscopo  5 , Elisa Fabrizi  5 , Francesco Della Gatta  6 , Andrea Merlo  7 , Nicola Vanacore  5
Affiliations

The Italian guideline on comprehensive geriatric assessment (CGA) for the older persons: a collaborative work of 25 Italian Scientific Societies and the National Institute of Health

Alberto Pilotto et al. Aging Clin Exp Res. .

Abstract

Background: The guideline was promoted by the Italian General Practitioners-Primary Care and Geriatrics Hospital-Community Societies and was carried out involving the National Institute of Health and an Expert Panel including representatives from 25 Scientific and Health-Professional Organizations. The aim of the Guideline was to develop evidence-based recommendations on the efficacy of CGA in older people across different clinical settings and the accuracy and utility of CGA-based tools to assess prognosis.

Methods: According to the methodological handbook of the Italian National System of Guidelines and NICE criteria (National Institute for Health and Care Excellence in England), the Guideline was produced based on the Grading of Recommendations Assessment, Development and Evaluation. Over 20,000 records gathered through databases searches were initially selected. Sixteen recommendations on CGA efficacy were defined based on 117 studies that met the inclusion criteria and were performed in general practices and primary care (26 studies included), medical and surgical clinics (16 studies), emergency departments (17 studies), hospital medical and surgical wards (53 studies), long-term care facilities and nursing homes (5 studies), hospices and palliative care networks (no studies). Nine recommendations on CGA-based prognostic tools were issues based on 42 included studies carried out in general practices and primary care (5 studies), medical and surgical clinics (4 studies), and hospital wards (33 studies).

Results: Using CGA can be useful to reduce hospitalization, mortality, institutionalization, the risk of delirium, and improve appropriateness in drug prescription and maintain functional activities in different settings. Further research on the efficacy of CGA in rehabilitative facilities, nursing homes, and hospice and palliative-care settings is recommended. CGA-based tools, particularly the Multidimensional Prognostic Index, should be used to predict some negative outcomes in different settings.

Conclusions: This Guideline may be useful in clinical practice and as a tool to support research on the use of CGA in older people.

Keywords: Comprehensive geriatric assessment; Guideline; Meta-analysis; Multidimensional prognostic index; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Efficacy of CGA compared to usual care in Randomized Clinical Trials across different settings
See this image and copyright information in PMC

References

    1. Parker SG, McCue P, Phelps K, McCleod A, Arora S, Nockels K, Kennedy S, Roberts H, Conroy S. What is comprehensive geriatric assessment (CGA)? An umbrella review. Age Ageing. 2018;47:149–155. doi: 10.1093/ageing/afx166. - DOI - PubMed
    1. Rubenstein LZ. Joseph T. Freeman award lecture: comprehensive geriatric assessment: from miracle to reality. J Gerontol A Biol Sci Med Sci. 2004;59:M473–M477. doi: 10.1093/gerona/59.5.M473. - DOI - PubMed
    1. Pilotto A, Cella A, Pilotto A, et al. Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Ass. 2017;18:192.e1–192.e11. doi: 10.1016/j.jamda.2016.11.004. - DOI - PubMed
    1. Zampino M, Polidori MC, Ferrucci L, O’Neill D, Pilotto A, Gogol M, Rubenstein L. Biomarkers of aging in real life: three questions on aging and the comprehensive geriatric assessment. GeroScience. 2022;44:2611–2622. doi: 10.1007/s11357-022-00613-4. - DOI - PMC - PubMed
    1. Gill TM. The central role of prognosis in clinical decision making. JAMA. 2012;307:199–200. doi: 10.1001/jama.2011.1992. - DOI - PMC - PubMed