Assessment of older adults by emergency medical services: Methodology and feasibility of a care partner comprehensive geriatric assessment (CP-CGA)

Canadian Journal of Emergency Medicine

Volumn 16, Issue 5, 2014, Pages 370-383

  Travers, Andrew ^b   Hubbard, Ruth ^a   Moorhouse, Paige ^a   Andrew, Melissa K ^a   Rockwood, Kenneth ^a  

^a DALHOUSIE UNIVERSITY   (Canada)

^b Emergency Health Services Nova Scotia   (United Kingdom)

Author keywords

Aged; Comprehensive Geriatric Assessment (CGA); Emergency medical services; Frail

Indexed keywords

AGED; ARTICLE; COMORBIDITY; COMPREHENSIVE GERIATRIC ASSESSMENT; ELDERLY CARE; EMERGENCY HEALTH SERVICE; FEMALE; GERIATRIC ASSESSMENT; GERIATRICS; HEALTH CARE QUALITY; HEALTH SERVICE; HUMAN; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; PATIENT SATISFACTION; PROSPECTIVE STUDY; QUESTIONNAIRE; RATING SCALE; VERY ELDERLY; CAREGIVER; FEASIBILITY STUDY; PROCEDURES; STATISTICS AND NUMERICAL DATA;

AGED; AGED, 80 AND OVER; CAREGIVERS; EMERGENCY MEDICAL SERVICES; FEASIBILITY STUDIES; FEMALE; GERIATRIC ASSESSMENT; HUMANS; MALE; PROSPECTIVE STUDIES; SURVEYS AND QUESTIONNAIRES;

EID: 84907159770     PISSN: 14818035     EISSN: 14818043     Source Type: Journal    
DOI: 10.2310/8000.2013.130937     Document Type: Article

References (32)

1. Louria DB. Extraordinary longevity: individual and societal issues. J Am Geriatr Soc 2005;53(9 Suppl):S317-9, doi:10. 1111/j.1532-5415.2005.53499.x.
2. Canadian Institute for Health Information. Understanding emergency department wait times: Who is using emergency departments and how long are they waiting? 2005. Available at: http://www.cihi.ca (accessed February 26, 2008).
3. Shah MN, Bazarian JJ, Lerner B, et al. The epidemiology of emergency medical services use by older adults: an analysis of the National Hospital Ambulatory Medical Care Survey. Acad Emerg Med 2007;14:441-8.
4. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002;39:238-47, doi:10.1067/mem.2002.121523.
5. Rockwood K, Fox RA, Stolee P, et al. Frailty in elderly people: an evolving concept. CMAJ 1994;150:489-95.
6. Hogan DB, MacKnight C, Bergman H. Models, definitions, and criteria of frailty. Aging Clin Exp Res 2003;15(3 Suppl): 1-29.
7. Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc 2010;58:681-7, doi:10.1111/ j.1532-5415.2010.02764.x.
8. Schuurmans H, Steverink N, Lindenberg S, et al. Old or frail: what tells us more? J Gerontol A Biol Sci Med Sci 2004; 59:M962-5, doi:10.1093/gerona/59.9.M962.
9. Rockwood K, Mitnitski A, Song X, et al. Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 2006;54: 975-9, doi:10.1111/j.1532-5415.2006.00738.x.
10. Goldstein JP, Andrew MK, Travers A. Frailty in older adults using pre-hospital care and the emergency department: a narrative review. Can Geriatr J 2012;15:16-22.
11. Mitnitski A., Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Sci World J 2001;1:323-36, doi:10.1100/tsw.2001.58.
12. Searle SD, Mitnitski A, Gahbauer EA, et al. A standard procedure for creating a frailty index. BMC Geriatr 2008; 8:24.
13. Rockwood K, Mitnitski A. Limits to deficit accumulation in elderly people. Mech Ageing Dev 2006;127:494-6, doi: 10.1016/j.mad.2006.01.002.
14. Rockwood K, Mitnitski A. How might deficit accumulation give rise to frailty? J Frailty Aging 2012;1(1):7-10.
15. Hastings NS, Purser JL, Johnson KS, et al. Frailty predicts some but not all adverse outcomes in older adults discharged from the emergency department. J Am Geriatr Soc 2008;56: 1651-7, doi:10.1111/j.1532-5415.2008.01840.x.
16. Jones DM, Song X, Rockwood K. Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc 2004;52:1929-33, doi:10.1111/j.1532-5415.2004.52521.x.
17. Rockwood K, Stadnyk K, Carver D, et al. A clinometric evaluation of specialized geriatric care for rural dwelling, frail older people. J Am Geriatr Soc 2000;48:1080-5.
18. Stuck AE, Siu AL, Wieland GD, et al. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993;342:1032-6, doi:10.1016/0140-6736(93)92884-V.
19. Ellis G, Whitehead MA, Robinson D, et al. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomized controlled trials. BMJ 2011; 343:d6553, doi:10.1136/bmj.d6553.
20. Samaras S, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-9, doi:10.1016/j.annemergmed.2010.04.015.
21. Emergency Health Services Nova Scotia. Annual report 2007/08. Available at: http://www.gov.ns.ca/health/ehs/(accessed January 1, 2009).
22. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011;27:17-26, doi:10.1016/j.cger.2010.08.008.
23. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173:489-95, doi:10.1503/cmaj.050051.
24. Goldstein J, Hubbard RE, Moorhouse P, Andrew MK. Feasibility of using information derived from a care partner to develop a frailty index based on comprehensive geriatric assessment. J Frailty Ageing 2013;2:15-21.
25. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56A:146-56, doi:10.1093/gerona/56.3.M146.
26. Gobbens RJJ, Van Assen MALM, Luijkx KG, et al. The predictive validity of the Tilburg frailty indicator: disability, health care utilization, and quality of life in a population at risk. Gerontologist 2012;1-13.
27. Steverink N, Slaets JPJ, Schuurmans H, et al. Measuring frailty, development and testing of the Groningen Frailty Indicator (GFI). Gerontologist 2001;41:236-7.
28. Rutschmann OT, Chevalley T, Zumwald Z, et al. Pitfalls in the emergency department triage of frail elderly patients without specific complaints. Swiss Med Wkly 2005;135: 145-50.
29. Lowthian JA, Jolley DJ, Curtis AJ, et al. The challenges of population ageing: accelerating demand for emergency ambulance services by older patients, 1995-2015. Med J Aust 2011;194:574-8.
30. Rockwood K, MacKnight C, Bergman H. Measuring frailty in geriatric patients [letter]. CMAJ 2006;174:353-4, doi: 10.1503/cmaj.1050249.
31. Conroy S. Emergency room geriatric assessment – urgent, important or both? Age Aging 2008;36:612-3, doi:10.1093/ageing/afn215.
32. Moorhouse P, Mallery L. PATH: a new approach to endof-life care. Can Rev Alzheimers Other Dementias 2010;13: 4-8.