Table 4.

Assessment tools and treatment/prevention of geriatric syndromes

Syndrome	Assessment tools	Possible interventions
Falls	Collecting anamnestic information on previous falls, comorbidity and medications Assessment of orthostatic hypotension [118] Evaluation of lower limb performance (Tinetti Scale) and sarcopenia (SPPB) [112] Risk of fracture (FRAX)	Promotion of physical activity and rehabilitation (including use of mobility aids), revision of pharmacological treatment and therapies for osteoporosis. Removal of environmental risk factors and increased risk awareness of family members [118, 119]
Delirium	Confusion assessment method 4AT Test [120, 121]	Systematic detection of acute clinical events. Mobilization, correction of sensory deficits, cognitive and orientation stimulation, encourage hydration, psychopharmacological therapy change and pain management [122]
Pressure sores	Predicting pressure ulcer risk (Braden Scale) Detection of predisposing factors Staging of present lesions [109]	Regular mobilization, repositioning, use of pressure injury prevention devices, treatment of predisposing factors (urinary/faecal incontinence, undernutrition). Systematic skin inspection in patients at risk [109, 123]
Urinary incontinence	Collecting anamnestic information Bladder diary [124, 125]	Treatment of reversible forms. Prompted or scheduled voiding. Removal of environmental obstacles. Avoid the use of bladder catheter to manage urinary incontinence [126] Choice of appropriate absorbent pads [124, 125]
Malnutrition	Body weight and mid-upper arm circumference monitoring [127] Sarcopenia assessment using dynamometer [113] Mini Nutritional Assessment or Malnutrition Universal Screening Tool (MUST) [128, 129] Evaluation of eating behaviour (Eating Behaviour Scale) [130]	Adequate nutritional intake. Appropriate care strategies. Focus on dysphagia (see below). Consider protein and energy supplements [131, 132]
Dysphagia	Screening for dysphagia (water swallow test) [133] Detect clinical conditions possibly related with dysphagia, including drug use (e.g. antipsychotics) [115]	Adaptation of food texture and fluid consistency to severity of dysphagia. Focus on posture during meal, oral hygiene and dentures. Medication review. Implement staff knowledge about careful feeding by hand in severe stages [134]
Chronic and recurrent pain	History of pain or risk factors for chronic pain. Detection of behavioural pain indicators with scales validated in dementia (PAINAD) [135]	Treatment of causes when possible. Physical activity and physiotherapy. Pharmacological pain management [100]

SPPB  short physical performance battery, FRAX Fracture Risk Assessment Tool