Outcomes of the Mobile Geriatric Clinic Service at Sena Hospital

Abstract

Objectives: 1) To assess the prevalence of geriatric syndromes in the elderly. 2) To evaluate the effectiveness of referrals to specialists and the continuity of follow-up care. 3) To examine the correlation between cognitive impairment and other geriatric syndromes. Methods: This is a cross-sectional survey study aimed at assessing the prevalence of geriatric syndromes in the elderly. The sample size was determined using Cochran's formula for prevalence studies, and the final sample was adjusted for the limited population using the Finite Population Correction (FPC), resulting in a total of 385 elderly individuals. Comprehensive geriatric assessments were performed using standard tools developed by the Department of Medical Services, Ministry of Public Health, to identify geriatric syndromes. Pearson’s correlation statistical analysis was applied to examine the correlation between cognitive impairment and other geriatric syndromes. Results: The most prevalent geriatric syndrome observed was instability, with 234 individuals identified as being at risk of falling (60.78%) and 52 individuals reporting a fall within the past six months (13.50%). The second most common condition was cognitive impairment, including mild cognitive impairment (MCI) in 157 individuals (40.78%) and dementia in 25 individuals (6.49%). The most frequent reason for referral to specialists was related to oral health issues. The most common issue was tooth loss, followed by vision problems, particularly cataracts. Among those referred to specialists, 94.02% attended their follow-up appointments. The main reasons patients did not attend follow-up appointments were lack of someone to accompany them to the hospital or a belief that their condition was not urgent. Cognitive impairment was found to have a significant correlation with urinary or fecal incontinence (p-value < 0.01 ) and instability (p-value < 0.05). It is possible that elderly individuals experiencing these symptoms may have a decline in social activities. Engaging in social interactions, meeting friends, conversing and participating in group activities are crucial in reducing the risk of cognitive impairment. Conclusion: The mobile geriatric clinic, established through the collaboration of a multidisciplinary team, serves as a model for delivering healthcare services to the elderly, enhancing their access to healthcare. Elderly individuals undergo a comprehensive geriatric assessment (CGA), receive appropriate care planning and are raised awareness about identifying age-related conditions. If these conditions are not addressed in a timely and appropriate manner, they can significantly impact the quality of life of the elderly and their caregivers. However, the CGA has limitations due to the time required for evaluation. In the future, it may be necessary to develop a more efficient assessment model.