Impact of geriatric syndrome burden on healthcare services utilization and mortality among community-dwelling older adults: is it still too late to do something?

Abstract

PurposeThe increasing longevity of the population emphasizes the need for a deeper understanding of geriatric syndromes and their implications for healthcare usage and mortality among older adults. This study aimed to identify risk factors associated with healthcare service utilization and mortality of community-dwelling adults aged 80 and older in YASAM project.MethodsThis prospective cohort study was part of the HEAT-YASAM trial, which focused on the community-based integrated healthy aging program for individuals aged 80 years and older in Bal & imath;kesir, T & uuml;rkiye. The burden of geriatric syndromes was assessed based on a comprehensive evaluation at least two domains of the nutrition, cognitive, physcological and locomotor capacities. The study outcome was healthcare services utilization (inpatient, outpatient, emergency admission) and all-cause mortality data obtained during follow-up period (9 months).ResultsThe cohort consisted of 5018 participants with a mean age of 85.8 years, predominantly female (53.1%). On the multivariable analysis, geriatric syndrome burden and Deyo Charlson Comorbidity index (D-CCI) score significant on independent predictors of 9-month mortality (p = 0.01). Higher geriatric syndrome burden was linked to an approximately 10% lower risk for outpatient admissions (p = 0.01) and every point increase in the D-CCI score was associated with a 1.3-fold increased risk of utilizing outpatient services (p = 0.01). For multimorbidity, every point increase corresponded to a 2.6-fold higher risk of inpatient admissions (p = 0.01) and a 1.2-fold higher risk of emergency admissions (p = 0.01).ConclusionsThis study demonstrate that a geriatric syndrome burden and multimorbidity has a significant impact on healthcare utilization and mortality in adults aged 80 years and older. Integrated comprehensive, coordinated, and patient-centered care models for this population facing multiple geriatric syndromes could positively impact the healthcare system.Trial registrationThe trial was prospectively registered at ClinicalTrials.gov. Identifier: NCT05993572 Registered on 15 July 2023.