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Prevalence and recognition of geriatric syndromes in an outpatient clinic at a tertiary care hospital of Thailand

Background: Geriatric syndromes are a series of clinical conditions in the elderly that do not fit into distinct categories. They affect the quality of life of a patient and are associated with disability. Objectives: This study determined the prevalence of geriatric syndromes in an Internal Medicine Outpatient setting. It compared the prevalence of each geriatric syndrome when using a comprehensive geriatric assessment versus the routine medical assessment. Methods: One hundred twenty elderly patients of the Internal Medicine Outpatient Clinic of Srinagarind Hospital Medical School were randomly reviewed between January 2008 and May 2010. Information on baseline characteristics and the presence of a geriatric syndrome was collected. Data for 50 patients assessed using a comprehensive geriatric assessment were reviewed prospectively and data for 70 patients assessed by a routine medical assessment were reviewed retrospectively. The prevalence for each syndrome was compared between two groups. Descriptive statistics and Chi-square test were used to analyze these outcomes. Results: The mean age and sex were not different between the two groups. Comparing the comprehensive geriatric assessment and routine medical assessment groups, there were, respectively, a prevalence of 30% vs. 1% for falls, 16% vs. 19% for dementia, 24% vs. 9% for urinary incontinence, 50% vs. 17% for functional dependency, and 22% vs. 14% for depression. Each syndrome was more prevalent with increasing age and in females. Falls (RR 2.79; 95% CI, 2.07-3.75), functional dependency (RR 2.24; 95% CI, 1.51-3.33) and urinary incontinence (RR 1.79; 95% CI, 1.18-2.70) had significantly higher prevalence in the comprehensive geriatric assessment group compared with the routine medical assessment group. Conclusions: Geriatric syndromes were highly prevalent in the elderly outpatient population. Under-recognition of these syndromes with routine medical assessments is common. Therefore, routine screening of these conditions by the comprehensive geriatric assessment is recommended.