Geriatric Syndromes and Mortality Among Hospitalized Older Adults

Thesis author

Adriana F. Dutra
Alexander K. Smith
Alexandra Malheiro
Ana Cristina C. Speranza
Arlety M.C. Casale
Beatriz N.A. Lopes
Clineu M. Almada-Filho
Danilsa V. De Sousa
Eduardo Ferriolli
Eduardo Marques Da Silva
Fabiola Sepulveda
Flavia Barreto Garcez
Gabriel T. Constantino
Gabriela S. Keller
Ianna L.S. Braga
Jonas Gordilho Souza
Juliana J.M. Teixeira
Karoline Rodrigues Da Silva Martins
Kenneth E. Covinsky
Laiane Moraes Dias
Lara M.Q. Araujo
Luana A.C. Macedo
Lucas G. De Andrade
Lucas K.P. Prado
Marco P.D. Freitas
Marcos D.C. Saraiva
Maria Aparecida C. Bicalho
Maria Carolyna F.B. Arbex
Maria E. Pires
Maria Fernanda B. Roma
Maria M.V. Guedes
Marina M.G. Borges
Milton L. Gorzoni
Mirella R. Bezerra
Natalia I.B. Garção
Natascha G.F. Palmeira
Nereida K.C. Lima
None None
Oberdã G. Moreira-Filho
Paulo José F. Villas Boas
Perola Q. De Almeida
Renata M. Dip
Renato G. Bandeira De Mello
Samir A. Aruachan
Sei J. Lee
Theodora Karnakis
Thiago J. Avelino-Silva
Vitor L. Pintarelli
Welma W.C.C. Amorim
Yngrid Dieguez Ferreira

Resumen

Importance: Geriatric syndromes are common in hospitalized older adults and complicate acute care; however, their overall prevalence and cumulative burden remain poorly understood, especially in resource-limited settings. Objectives: To measure the prevalence of geriatric syndromes upon hospital admission and examine the independent association between the number of geriatric syndromes and 90-day mortality. Design, Setting, and Participants: This cohort study used data from the Creating a Hospital Assessment Network in Geriatrics (CHANGE) study, a multicenter, prospective cohort of 43 hospitals, including 38 in Brazil, 1 in Angola, 1 in Chile, 2 in Colombia, and 1 in Portugal. Consecutive patients aged 65 years or older admitted under geriatric teams between June 1, 2022, and December 31, 2023, were enrolled within 48 hours; patients with terminally illness were excluded. Data were analyzed from February 1 to November 23, 2025. Exposure: A standardized comprehensive geriatric assessment captured 14 geriatric syndromes: loneliness, dementia, depressive symptoms, sensory impairment, disability, immobility, incontinence, falls, frailty, malnutrition, pressure ulcers, polypharmacy, potentially inappropriate medications, and delirium. The exposure of interest was the within-patient count of syndromes. Main Outcomes and Measures: The primary outcome was 90-day all-cause mortality, ascertained by masked telephone follow-up with verification in medical records or public registries. Prespecified mixed-effects Cox proportional hazards regression were performed. Results: The study included 2556 participants (mean [SD] age, 79 [9] years, 1437 female [56.2%]). The median number of geriatric syndromes was 5 (IQR, 3-8). The highest prevalence rates for syndromes were 70.8% (95% CI, 69.1%-72.6%) for disability, 61.7% (95% CI, 59.8%-63.6%) for polypharmacy, 58.2% (95% CI, 56.3%-60.1%) for frailty, and 54.7% (95% CI, 52.8%-56.7%) for sensory impairment. Across categories, the mortality rate rose from 8.4% (95% CI, 6.2%-11.4%) for 0 to 2 syndromes to 12.7% (95% CI, 10.1%-15.7%) for 3 to 4 syndromes, 25.4% (95% CI, 22.2%-29.1%) for 5 to 6 syndromes, 30.4% (95% CI, 26.7%-34.5%) for 7 to 8 syndromes, 39.5% (95% CI, 34.4%-44.8%) for 9 to 10 syndromes, and 47.0% (95% CI, 36.4%-57.9%) for 11 or more syndromes. After adjusting for confounders, each additional geriatric syndrome was associated with an increased risk of mortality (hazard ratio, 1.22 [95% CI, 1.15-1.30), which became increasingly pronounced in older age groups. Conclusions and Relevance: This cohort study found that hospitalized older adults had a median of 5 geriatric syndromes, which were independently and incrementally associated with 90-day mortality. Multidomain assessments should be integrated into standard hospital care to identify and address vulnerabilities that commonly affect older adults with acute illness.

autores

http://vivoweb.org/ontology/core#FacultyMember
Venegas Sanabria, Luis Carlos

fecha de publicación

2026-1-1

Área temática

Hambre cero

Edición

9

VIVO
VIVO

Geriatric Syndromes and Mortality Among Hospitalized Older Adults Artículo académico

Perfil

Thesis author

Resumen

autores

fecha de publicación

Área temática

Edición

Identidad

Identificador de objeto digital (DOI)

Comprometidos
con la calidad