Geriatrics

CGA-ward improved function, utility, and saved costs versus usual care in hospitalized frail older adults

In a Thailand cohort (n=226; 45 CGA-ward, 89 CGA-consult, 92 usual care), CGA-ward produced an incremental EQ-5D-5L utility gain of 0.259 versus usual care. CGA-ward also yielded a mean functional gain of 37.94 on the Barthel Index and was associated with US$937 in societal savings per patient. CGA-consult showed a smaller utility gain (incremental mean 0.093) and lower savings, making consults a pragmatic alternative when ward care is infeasible. Authors used IPTW-adjusted regression and report negative ICERs (cost-saving) for both CGA models versus usual care. 1

Umbrella review: frailty and its subtypes predict mortality and diverse adverse outcomes

This umbrella review pooled 37 systematic reviews and meta-analyses and found frailty doubled mortality risk (pooled RR 2.07) and prefrailty increased mortality risk (pooled RR 1.38). Frailty was consistently associated with higher risks of hospitalization, institutionalization, falls, fractures, cognitive decline, depression, and in-hospital adverse events. Cognitive frailty showed a markedly higher dementia risk (pooled RR 3.75), and multidimensional frailty conveyed the highest mortality risk. Most non-pooled outcomes had low-to-moderate certainty, so effect direction is reliable but some magnitudes remain uncertain. 2

eHealth modestly reduces burden and depressive symptoms in informal dementia caregivers

Meta-analysis of 35 RCTs (N=3388) found eHealth interventions reduced caregiver burden (SMD -0.26) versus control. Depressive symptoms were modestly reduced (SMD -0.27), but prediction intervals were wide, reflecting substantial heterogeneity. Subgroup signals favored short-term, mobile, or human-supported interventions, and caregiver age moderated effects. Certainty was moderate; real-world benefit will vary by intervention format and caregiver context. 3