Age-Friendly Telegeriatrics: Evidence and a 5M-Based Framework for Hybrid Geriatric Care in Saudi Arabia

Population ageing is increasing demand for accessible, coordinated, and person-centered care, while many older adults face barriers to conventional services related to frailty, multimorbidity, cognitive or sensory impairment, functional dependency, and travel burden. Telehealth can extend specialist expertise beyond conventional clinical settings, but geriatric care cannot be reduced to transferring a standard outpatient consultation to video. This narrative review synthesizes contemporary evidence on telegeriatrics, including virtual comprehensive geriatric assessment (CGA), cognitive and functional assessment, medication review, chronic-disease monitoring, rehabilitation, home-based care, and caregiver-supported models, with particular attention to Saudi Arabia. Evidence supports the feasibility and acceptability of several telegeriatric applications, although clinical effectiveness, cost-effectiveness, and long-term outcomes remain heterogeneous. Important limitations include digital exclusion, sensory and cognitive barriers, restricted physical examination, interoperability challenges, and the risk of shifting additional work to family caregivers. Emerging Saudi evidence demonstrates both rapid expansion of virtual-care infrastructure and growing experience with telehealth among older adults, including multidisciplinary tele-CGA through Seha Virtual Hospital, but geriatric-specific outcome evidence remains limited. Based on the narrative synthesis, an author-proposed, evidence-informed conceptual framework is presented to illustrate how the Geriatric 5Ms may inform the integration of virtual and in-person geriatric care. This framework has not undergone formal consensus development, prospective validation, or effectiveness testing. It is intended to support discussion, inform future research, and provide a starting point for prospective feasibility and implementation studies rather than serve as a clinical practice recommendation.