השוואת שיטות

	Comprehensive Geriatric Assessment	Deficit-Accumulation Frailty Index
תחום	Social Gerontology	Social Gerontology
משפחה	Process / pipeline	Process / pipeline
שנת המקור	1993	2001
הוגה השיטה	Andreas E. Stuck, Laurence Z. Rubenstein and colleagues (meta-analytic synthesis)	Arnold Mitnitski & Kenneth Rockwood
סוג	Multidimensional interdisciplinary diagnostic and care-planning process	Continuous index of frailty as accumulated health deficits
מקור מכונן	Stuck, A. E., Siu, A. L., Wieland, G. D., Adams, J., & Rubenstein, L. Z. (1993). Comprehensive geriatric assessment: a meta-analysis of controlled trials. The Lancet, 342(8878), 1032-1036.	Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001). Accumulation of deficits as a proxy measure of aging. The Scientific World Journal, 1, 323-336.
כינויים	CGA, Geriatric Assessment, Multidimensional Geriatric Assessment, Interdisciplinary Geriatric Evaluation	Frailty Index, Rockwood Frailty Index, Deficit Accumulation Index, FI-CGA
קשורות	3	4
תקציר	Comprehensive Geriatric Assessment (CGA) is a multidimensional, interdisciplinary diagnostic process that evaluates an older person's medical, functional, cognitive, psychological, social, and environmental status and translates the findings into a coordinated, monitored plan of care. Rather than treating a single presenting complaint, CGA assumes that vulnerability in late life is multifactorial and that problems in one domain spill over into others. Stuck and colleagues' landmark 1993 meta-analysis of controlled trials showed that CGA is not merely descriptive: when it includes control over the implementation of recommendations and structured follow-up, it reduces mortality, increases the chance of living at home, and improves physical and cognitive function. The same synthesis clarified that assessment alone, without the power to act on findings and to follow patients over time, yields little benefit. CGA thus reframed geriatric care around systematic, team-based evaluation linked to action. It became the organizing model for geriatric medicine units, outpatient geriatric clinics, and home-assessment programs worldwide. The method is best understood as a process, not a single scale, even though it is built from many validated instruments.	The deficit-accumulation frailty index measures frailty as the proportion of a long list of age-related health deficits that a person has accumulated. Introduced by Arnold Mitnitski and Kenneth Rockwood in 2001, it treats frailty not as a fixed syndrome but as a quantitative state: the more things have gone wrong across many body systems, the frailer the person. Counting 30 or more deficits — symptoms, signs, diseases, disabilities, and laboratory abnormalities — and dividing by the number considered yields a continuous score between 0 and 1 that rises with age, predicts mortality and adverse outcomes, and behaves remarkably consistently regardless of exactly which deficits are used. A standardized procedure by Searle and colleagues made the index easy to construct from existing data.