社区老年人综合评估研究进展及应用综述

A review on the research progress and application of comprehensive geriatrie assessment for community-dwelling older people

老年综合评估是一种多维度、跨学科的评估方法,能够早期发现老年人潜在的问题和功能缺陷,减少跌倒、失能、住院、死亡等不良结局的发生,降低社会的医疗和照护负担。现有国外的评估工具包括欧洲老年人评估系统、国际居民评估工具、多维预后指数、患者报告结局测量信息系统,这些是更为标准化、体系化的老年综合评估工具。国内是由各研究机构基于一定理论框架,精选各个维度单项量表的评估内容,并对整个量表的信效度进行验证和评价,多为单一场景应用的老年综合评估工具。目前国内外老年综合评估研究对象更关注急诊、住院患者,对于社区老年群体关注较少。另外,国内实施社区老年综合评估的循证医学证据不足,缺失前瞻性和干预性研究。本文对国内外社区综合评估研究工具研制和应用情况进行综述,探讨目前社区老年综合评估研究遇到的问题和可能的解决方案,以期将预防和控制老年人健康危险因素的关口前移、延缓不良事件的发生发展、降低照护负担、提高老年人生活质量。

The comprehensive geritric ssessment(CGA)is a mutidimensional and intendisciplinary evaluation approach for the elderly people that aims to identify potential health problems and functional deficits in multiple aspects of individuals.The current foreign CGA instuments are more standardized and systematic than Chinese,including European Assessment System for Care of Old People,Mutidimensional Prognostic Index,Patient-Reported Outcomes Measurement Information System.In China,research institutions based on certain theoretical frameworks select evaluation contents of various dimensions and conduct verification of the reliability and validity of the entire scale,which mostly applied in single scenarios.Currently,domestic and foreign CGA studies focus more on emergency and bospitalized patients with less atention to the elderly population in the coomumity.Furthermore,there is a lack of evidence-based medicine evidence,and prospective and intervention studies in the implementation of community elderly comprehensive evaluation in China.This review article provides the development and appicaion of CGA instruments in ommunity-delling people both domestically and intenationally.It also explores the problems currently faced by community elderly CGA research and potential solutions,in order to move the front line of preventing and controlling health risks for the elderly,delay the occurrence and development of advese events,reduce the burden of care in society,and improve the quality of life for the elderly.