ALIGN-CARE: An Age-Friendly Surgical Co-Management Model Guided by the 7Ms Framework: Preliminary Data

Area of Science:

• Geriatric Medicine
• Surgical Care
• Public Health

Background:

• Frail older adults face elevated risks for postoperative complications and functional decline.
• Limited feasible ambulatory preoperative assessment options exist for this population.
• Comprehensive Geriatric Assessment (CGA) is recognized for its value in surgical care.

Purpose of the Study:

• To evaluate the feasibility and clinical utility of an ambulatory preoperative geriatrics program.
• To assess the 7Ms framework, an extended CGA model, for identifying geriatric syndromes and guiding interventions.
• To determine the prevalence of geriatric syndromes and the types of recommendations generated.

Main Methods:

• Prospective cohort study of 65+ year old surgical patients (n=63) from January 2022 to May 2024.
• Utilized CGA guided by the 7Ms framework (including Maintaining Care and Meals).
• Collected data on geriatric syndromes, preoperative recommendations, and program feasibility metrics.

Main Results:

• Geriatric syndromes were highly prevalent: assistive device use (60.3%), frailty (22.2%), polypharmacy (~90%), cognitive impairment (54.1%).
• Nutritional risks identified in 42.6% (at risk) and 9.8% (malnourished).
• The 7Ms framework yielded an average of 11.2 recommendations per patient, focusing on care coordination, physical therapy, deprescribing, and delirium prevention.

Conclusions:

• A structured CGA using the 7Ms framework is feasible and clinically beneficial in ambulatory preoperative settings.
• The 7Ms framework pragmatically identifies geriatric vulnerabilities and supports preoperative optimization.
• This approach enhances care coordination and nutritional assessment for older surgical patients.