COMPREHENSIVE GERIATRIC ASSESSMENT - A METAANALYSIS OF CONTROLLED TRIALS

There is disagreement on the usefulness of comprehensive geriatric ass essment (CGA) due to conflicting results from individual trials. We di d a meta-analysis on 28 controlled trials comprising 4959 subjects all ocated to one of five CGA types and 4912 controls. Published data were supplemented with reanalysed data provided by the original investigat ors. We calculated combined odds ratios of important outcomes by pooli ng data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at fol low-up was 1.68 (1.17-2.41) for geriatric evaluation and management un its, 1.49 (1.12-1.98) for hospital-home assessment services, and 1.22 (1.05-1.37) for home assessment services. Covariate analysis showed th at programmes with control over medical recommendations and extended a mbulatory follow-up were more likely to be effective. Our analysis sug gests that CGA programmes linking geriatric evaluation with strong lon g-term management are effective for improving survival and function in older persons.