Geriatric Syndromes and Mortality Among Hospitalized Older Adults

Area of Science:

• Geriatric Medicine
• Internal Medicine
• Public Health

Background:

• Geriatric syndromes are prevalent in hospitalized older adults, complicating care and impacting outcomes.
• Their cumulative burden and association with mortality are not well understood, particularly in resource-limited settings.

Purpose of the Study:

• To determine the prevalence of geriatric syndromes at hospital admission.
• To examine the association between the number of geriatric syndromes and 90-day mortality.

Main Methods:

• A multicenter prospective cohort study (CHANGE study) involving 2556 patients aged 65+ across 43 hospitals in multiple countries.
• Standardized comprehensive geriatric assessment identified 14 geriatric syndromes.
• Mixed-effects Cox proportional hazards regression analyzed the association with 90-day mortality.

Main Results:

• The median number of geriatric syndromes per patient was 5.
• High prevalence rates observed for disability (70.8%), polypharmacy (61.7%), frailty (58.2%), and sensory impairment (54.7%).
• Mortality risk increased incrementally with the number of syndromes, with each additional syndrome associated with a 22% increased risk of 90-day mortality (HR, 1.22).

Conclusions:

• Hospitalized older adults frequently present with multiple geriatric syndromes.
• The number of geriatric syndromes is independently and incrementally associated with increased 90-day mortality.
• Integrating multidomain assessments into routine hospital care is crucial for identifying and managing geriatric vulnerabilities.