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 heightened surgical risks, including 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 a 7Ms framework-guided CGA in an ambulatory preoperative setting.
• To identify geriatric syndromes and guide preoperative optimization for older surgical patients.

Main Methods:

• Prospective cohort study of patients aged 65+ undergoing ambulatory preoperative geriatrics assessment.
• Utilized the 7Ms framework (including Maintaining Care and Meals) for CGA.
• Collected data on geriatric syndromes, recommendations, and program feasibility.

Main Results:

• Sixty-three patients (mean age 81.7) were enrolled; geriatric syndromes were prevalent (e.g., polypharmacy ~90%, cognitive impairment 54.1%).
• Nutritional risks identified in 42.6% (at risk) and 9.8% (malnourished).
• The 7Ms framework generated 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 useful preoperatively.
• The 7Ms framework pragmatically addresses care coordination and nutrition for geriatric vulnerability assessment.
• This approach supports preoperative optimization for older adults undergoing surgery.