Abstract 4369172: Comprehensive Geriatric Assessment Reduces Cardiovascular Mortality and Heart Failure Hospitalizations in Older Adults: A Systematic Review and Meta-analysis

Abstract

Background: Cardiovascular disease management in older adults is complicated by geriatric syndromes. Comprehensive Geriatric Assessment (CGA)—a multidisciplinary evaluation of functional, cognitive, nutritional, and social domains—may improve outcomes, but its effects on cardiovascular-specific endpoints remain unquantified. Research Question: Does CGA reduce cardiovascular mortality and hospitalizations in adults ≥65 years with cardiovascular disease compared to usual care? Methods: We conducted a PRISMA-compliant systematic review and meta-analysis of 15 studies (9 randomized controlled trials, 4 cohorts, 2 quasi-experimental; n=3,632) from PubMed, EMBASE, Cochrane, Web of Science, and CINAHL (2005–2025). Included studies implemented multidisciplinary CGA (≥3 domains) in older adults with cardiovascular conditions. Primary outcomes were cardiovascular mortality, heart failure hospitalization, acute coronary syndrome events, stroke, and 30-day readmissions. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models. Results: CGA significantly reduced cardiovascular mortality by 18% (9 studies; RR 0.82, 95% CI 0.75–0.90; p<0.001), heart failure hospitalizations by 24% (7 studies; RR 0.76, 0.68–0.85; p<0.001), and 30-day readmissions by 15% (6 studies; RR 0.85, 0.77–0.94; p=0.002). Greatest benefits occurred in frail patients (heart failure hospitalization RR 0.72, 0.65–0.80; p<0.01) and with ≥4 CGA domains (mortality RR 0.78, 0.71–0.86). No significant effects were observed for acute coronary syndrome (RR 0.92, 0.80–1.05) or stroke (RR 0.97, 0.83–1.18). Conclusions: CGA reduces cardiovascular mortality and heart failure hospitalizations in older adults, particularly frail individuals. Integration into cardiology-geriatrics collaborative models is recommended. Disease-specific adaptations may be needed for acute coronary syndrome and stroke.