Avaliação geriátrica ampla (AGA): viabilidade e confiabilidade da versão autoaplicável

Abstract

Background:Comprehensive Geriatric Assessment (CGA) is considered best practice for clinical decision-making and management in the care of older adults. However, its widespread implementation is limited by the shortage of geriatric specialists. Mobile self-administered tools may improve access to multidimensional geriatric evaluation, particularly in resource-constrained settings. Objective: To assess the feasibility of a mobile self-administered CGA and compare it with provider administered assessments in older adults in Brazil. Methods: This was a cross-sectional study conducted in both an outpatient clinic and an inpatient unit in Brasília, Federal District, Brazil. A total of 80 older adults (≥60 years), literate in Portuguese and capable of providing informed consent, completed the digital self-administered CGA. Within 24 hours, a geriatrician conducted the conventional provider-administered CGA. Agreement between versions was analyzed using the Wilcoxon signed-rank test, Spearman’s rank correlation, intraclass correlation coefficients (ICC), and Cohen’s Kappa statistic to assess item-level agreement. Results: Participants had a mean age of 70 years; 60% were female, and 68% had low educational attainment. High concordance was statistically observed between the self-administered and provider-administered versions for objective domains, including history of falls (κ = 0.878, p < .001), hearing (κ = 0.826), and vision (κ = 0.634). No significant differences were found in the scores of standardized instruments, Vulnerable Elders Survey (VES-13), Geriatric 8 (G8), Geriatric Depression Scale (GDS-5), and Cognitive Function Screening (CCQ-8), except for subjective domains such as nutritional status and social vulnerability. Among inpatients, MNA and Gijón scale showed significant discrepancies (p ≤ .050), with providers reporting greater vulnerability. The average completion time for the self-administered mobile version was 18 minutes, and 90% of participants rated it as easy or very easy to use. Conclusion: The mobile self-administered CGA demonstrated high usability and strong agreement with provider assessments. It appears to be a feasible tool for screening and triage, especially in settings with limited access to geriatric specialists. This approach offers a promising strategy to expand geriatric assessment to guide diagnosis and disease management using mobile technology in middle-income countries.