TY - JOUR
AU - L. Chai
AU - N. Gou
A1 - 
AB - BACKGROUND: The health conditions of elderly people who have multiple chronic illnesses and geriatric syndromes lead to severe health problems, which result in decreased ability to function and increased need for medical services. METHODS: The study used a retrospective cohort design with propensity score matching and multivariable modeling to examine the impact of different care models on outcomes over a 24-month period. Five outcomes including hospitalization rates and functional decline rates through ADL and IADL assessments, cognitive decline rates, mortality rates, and service usage rates. RESULTS: The matching process achieved balanced baseline characteristics between groups because SMD measurements stayed below 0.05. Geriatric syndromes had high prevalence rates with 40.0% cognitive impairment, 32.0% frailty, 32.5% depression, 49.0% polypharmacy, and 68.5% multimorbidity. The health service utilization showed substantial levels, which included 92 hospital admissions per 100 person-years and 134 emergency visits per 100 person-years. 31.4% of participants experienced functional decline in activities of daily living ADL and 42.7% suffered a similar decline in instrumental activities of daily living IADL while EQ-5D showed quality-of-life deterioration of -0.04. Integrated care provided benefits which decreased hospital admissions (IRR 0.78, 95% CI 0.71-0.87) and 30-day readmissions (OR 0.81) and reduced length of stay (-1.2 days). Cognitive decline underwent partial protection (MoCA change +0.86; dementia conversion HR 0.71), and mortality decreased (HR 0.76). Multivariable models show that frailty (OR 2.21) and cognitive impairment (OR 1.42) served as strong predictors of functional decline. The protective effects of integrated care continued to exist (OR 0.81). Mediation analysis suggested that approximately 25% of the observed advantage came from reduced frailty. CONCLUSION: Older adults exhibit high burdens of geriatric syndromes and healthcare utilization, which leads to their functional and cognitive decline. Integrated care models reduce hospital admissions and delay cognitive decline while increasing patient survival because they help manage frailty and provide unified treatment.
AD - Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
AN - 42445168
BT - Front Med (Lausanne)
C5 - Healthcare Disparities
DO - 10.3389/fmed.2026.1820760
DP - NLM
ET - 20260629
JF - Front Med (Lausanne)
LA - eng
N2 - BACKGROUND: The health conditions of elderly people who have multiple chronic illnesses and geriatric syndromes lead to severe health problems, which result in decreased ability to function and increased need for medical services. METHODS: The study used a retrospective cohort design with propensity score matching and multivariable modeling to examine the impact of different care models on outcomes over a 24-month period. Five outcomes including hospitalization rates and functional decline rates through ADL and IADL assessments, cognitive decline rates, mortality rates, and service usage rates. RESULTS: The matching process achieved balanced baseline characteristics between groups because SMD measurements stayed below 0.05. Geriatric syndromes had high prevalence rates with 40.0% cognitive impairment, 32.0% frailty, 32.5% depression, 49.0% polypharmacy, and 68.5% multimorbidity. The health service utilization showed substantial levels, which included 92 hospital admissions per 100 person-years and 134 emergency visits per 100 person-years. 31.4% of participants experienced functional decline in activities of daily living ADL and 42.7% suffered a similar decline in instrumental activities of daily living IADL while EQ-5D showed quality-of-life deterioration of -0.04. Integrated care provided benefits which decreased hospital admissions (IRR 0.78, 95% CI 0.71-0.87) and 30-day readmissions (OR 0.81) and reduced length of stay (-1.2 days). Cognitive decline underwent partial protection (MoCA change +0.86; dementia conversion HR 0.71), and mortality decreased (HR 0.76). Multivariable models show that frailty (OR 2.21) and cognitive impairment (OR 1.42) served as strong predictors of functional decline. The protective effects of integrated care continued to exist (OR 0.81). Mediation analysis suggested that approximately 25% of the observed advantage came from reduced frailty. CONCLUSION: Older adults exhibit high burdens of geriatric syndromes and healthcare utilization, which leads to their functional and cognitive decline. Integrated care models reduce hospital admissions and delay cognitive decline while increasing patient survival because they help manage frailty and provide unified treatment.
PY - 2026
SN - 2296-858X (Print); 2296-858x
SP - 1820760
ST - Burden of geriatric and cognitive disorders and the impact of integrated care models on morbidity, functional decline, and health service utilization among older adults
T1 - Burden of geriatric and cognitive disorders and the impact of integrated care models on morbidity, functional decline, and health service utilization among older adults
T2 - Front Med (Lausanne)
TI - Burden of geriatric and cognitive disorders and the impact of integrated care models on morbidity, functional decline, and health service utilization among older adults
U1 - Healthcare Disparities
U3 - 10.3389/fmed.2026.1820760
VL - 13
VO - 2296-858X (Print); 2296-858x
Y1 - 2026
ER -