Which older people are most likely to benefit from community-based comprehensive geriatric assessment (CGA)? An individual participant data meta-analysis of trials
Background
Maintaining independence in later life is a major priority for both older people and the NHS. Community-based comprehensive geriatric assessment (CGA) is an approach that provides personalised care planning, including medication review and regular follow-up, to help older people remain independent and living at home for longer. Existing evidence suggests these interventions may improve day-to-day functioning and slightly increase the likelihood of remaining at home rather than requiring institutional care. However, it remains unclear which groups of older people benefit most from these services. This project aims to address that evidence gap and improve targeting of care for older adults.
Aims and Objectives
The aim of this project is to identify which older people are most likely to benefit from community-based comprehensive geriatric assessment (CGA).
The objectives are to:
- Bring together individual participant data from previous trials of community-based CGA and personalised care planning interventions.
- Investigate whether outcomes differ according to factors such as frailty, physical and mental health conditions, and socioeconomic circumstances.
- Identify which groups of older people gain the greatest benefit from these interventions.
- Provide evidence that can help healthcare providers target services more effectively and maximise independence in later life.
Methods
This study is an individual participant data meta-analysis (IPDMA). Researchers will collect and combine original participant-level data from existing studies of community-based CGA and individualised care planning programmes. The data from each study will be standardised to make datasets compatible and suitable for combined analysis.
Using advanced statistical methods, the research team will explore whether specific characteristics, including frailty, long-term health conditions and levels of deprivation, influence how individuals respond to these interventions. This approach will allow the team to understand not only whether community-based CGA works, but also who benefits most.
Further Information
This project is led by Professor Andrew Clegg, Professor of Geriatric Medicine at the University of Leeds. The study is being undertaken in collaboration with the Ageing Research Trialists (ART) collaborative and multiple international contributors who have conducted relevant clinical trials.
The research aligns with national priorities to support healthy ageing, reduce health inequalities and improve care for people living with frailty. Findings are expected to inform policymakers, healthcare providers and international organisations, including the Department of Health and Social Care and the World Health Organization, helping to improve services for older people in the UK and beyond.
