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Agreement Between a Mobile Self-Administered Comprehensive Geriatric Assessment Screening Tool and
Daniele Fabrino Cupertino Queirod De Oliveira1,2,3, Ana Paula Cupertino4, Samara Morais Silveira5
1Escola Superior de Ciências da Saúde (ESCS), Universidade do Distrito Federal (UnDF), Brasília, Brazil.
Background:
Comprehensive geriatric assessment (CGA) is a widely recommended, multidimensional approach for guiding clinical decision-making and management in older adults. However, its implementation remains limited by a shortage of geriatric specialists, the complexity of geriatric care, and the increasing demands of an aging population. Mobile self-administered tools offer a potential strategy to expand access to multidimensional geriatric evaluation, particularly in resource-limited settings.
Objective:
This study aimed to evaluate the feasibility and agreement of a mobile self-administered CGA screening tool compared with geriatrician-administered assessments among inpatient and outpatient older adults in Brazil.
Methods:
This cross-sectional study included 80 older adults recruited from inpatient and outpatient geriatric clinics in Brasília, Brazil. Participants completed a mobile CGA, which incorporated validated instruments covering functional status (Vulnerable Elders Survey-13 [VES-13]), cognition (Cognitive Change Questionnaire-8 [CCQ-8]), depressive symptoms (5-item Geriatric Depression Scale [GDS-5]), nutritional status (Mini Nutritional Assessment [MNA]), frailty (G8 screening tool), social support (Gijón Scale), falls, and vision and hearing. Within 48 hours, a geriatrician independently performed a geriatrician-administered CGA using the same instruments. Agreement between the 2 assessment methods was evaluated using Wilcoxon signed-rank tests, Spearman correlation coefficients, intraclass correlation coefficients (ICCs), and Cohen κ coefficients for categorical variables.
Results:
Participants had a mean age of 70 (SD 7) years; 58.8% (47/80) were female, and 65% (52/80) had ≤8 years of education. The mean completion time for the self-administered CGA was 18.5 (SD 7.5) minutes. Most participants rated the tool as easy or very easy to use (65/80, 81.3%) and reported satisfaction with the assessment process (n=79, 98.8%). High concordance was observed between the self-administered and geriatrician-administered CGA versions for most domains. Cohen κ coefficients demonstrated strong agreement for falls (κ=0.878; P<.001), hearing impairment (κ=0.826), and vision impairment (κ=0.634). No significant differences were observed between the 2 assessment methods for functional status (VES-13), frailty screening (G8), depressive symptoms (GDS-5), and cognition (CCQ-8). Nutritional status and social vulnerability showed lower concordance than other CGA domains. Among inpatients, significant discrepancies were identified in both nutritional scores and Gijón social risk scores (P≤.05), with participants reporting greater perceived vulnerability. For outpatients, significant differences were observed for nutritional status (MNA; P=.02) and frailty screening (G8; P=.046).
Conclusions:
A mobile self-administered CGA demonstrated good feasibility, high user satisfaction, and substantial agreement with geriatrician-administered assessments across multiple geriatric domains. The tool may support geriatric screening and triage in settings with limited specialist availability, particularly when used as a complement to comprehensive clinical assessment.