Abstract
In a country with a large ageing population and a health system of debatable efficiency, accessing and receiving health care in twilight years is not an easy proposition. Chronic disease, functional impairment, cognitive decline, lack of social and health security; and declining traditional support system render the “older” segment of the population extremely vulnerable. With very little orientation in old age care, health professionals do not have capacity to resolve complex geriatric syndromes in busy outpatient clinics. We assessed the ability of EASYCare in assessment of vulnerable older clients in outpatient department in detecting geriatric syndromes vis-à-vis comprehensive geriatric assessment. In this cross sectional study persons aged 65 years or more seeking care from Outpatient Department(OPD) of Geriatric Medicine service of All India Institute of Medical Sciences Hospital in India were included.600 consenting participants were assessed with the EASYCare Standard 2010 instrument, which was self-administered with the help of a trained Medical Social Worker. This was followed by independent comprehensive assessment by a geriatrician which specifically included of Hindi Mental State Examination (HMSE), Geriatric Depression Scale (GDS), International Consultation on Incontinence Questionnaire (ICIQ), and fall questionnaire. Four geriatric syndromes, namely, cognitive impairment, depression, falls and urinary incontinence were used as index syndromes for this study. The mean age of the participants was 71 years with a significant male predominance (70%).One or more geriatric syndromes were present in 77% of the individuals with 2% having all four geriatric syndromes and 42% having two or more geriatric syndromes. Based on EASYCare assessment, cognitive impairment was the most common geriatric syndrome (62%),followed by depression (36%), falls (24%), and urinary incontinence (14%).The prevalence of incontinence and cognitive impairment showed significant association with increasing age {(p<0.05),(p=0.01)}.EASYCare assessment data showed a concordance of 98%,70%,and 40% with CGA assessment for incontinence, depression, cognitive impairment respectively EASYCare could detect very relevant geriatric syndromes in older patients in an OPD setting in a time and cost efficient manner.