Background: Comprehensive geriatric assessment (CGA) is a person-centred, multidisciplinary model of care that identifies and addresses the complex needs of older adults. As populations continue to age, CGA is increasingly relied upon to deliver effective, sustainable, and high-quality care. Although initially developed for frail older adults in hospital settings, CGA is now widely implemented across clinical specialties, including emergency medicine, surgery, orthopaedics, oncology, and nephrology, as well as community, ambulatory, and long-term care settings. Despite its widespread use, variation in the outcomes measured and reported across CGA studies limits comparison of findings and evidence synthesis. A Core Outcome Set (COS) is therefore needed to standardise outcome reporting and improve the quality and comparability of future research.
Existing COS involving older adults have largely focused on specific conditions, interventions, or care settings, including frailty (Prorok et al., 2022), delirium (e.g., Russell et al., 2024), malnutrition (e.g., Mendonça et al., 2024), geriatric rehabilitation (e.g., Demers et al., 2004), and emergency department care (e.g., McLoughlin et al., 2026). Although these COS address outcome standardisation within specific contexts, there remains a need for a common set of outcomes applicable to older adults undergoing CGA across clinical specialties and care settings. The proposed COS therefore aims to build on existing work by identifying a common set of outcomes relevant to older adults undergoing CGA, irrespective of the specific condition, specialty, or care setting in which CGA is delivered.
Aim: The aim of this project is to develop an evidence- and consensus-based COS for research evaluating the effectiveness of CGA for older adults.
The study will follow best-practice guidance from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative, with older adults actively involved as research partners throughout the project.
The research will be conducted in five stages:
1. Umbrella review: Identify outcome domains and measurement instruments reported in systematic reviews of CGA to develop an initial list of outcomes.
2. Rapid qualitative evidence synthesis: Identify outcomes that matter to older adults by synthesising evidence on their experiences of CGA across settings and specialties.
3. Qualitative study: Explore outcomes considered important by older adults, family members, researchers, and healthcare professionals.
4. Real-Time Delphi study: Achieve international consensus on the core outcome domains through stakeholder prioritisation of candidate outcomes.
5. Consensus meeting: Agree the final Core Outcome Set and identify appropriate outcome measurement instruments for each core outcome.
Dr Ailbhe Dempsey - Post-doctoral researcher - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Prof Rose Galvin - Principal Investigator - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Prof Simon Conroy - Researcher Co-applicant - Consultant geriatrician, The Royal London Hospital, Whitechapel Road, London, E1 1FR. Honorary Professor of Geriatric Medicine, Wolfson Institute of Population Health, Queen Mary University of London.
Dr Christine FitzGerald - Researcher Co-applicant - School of Nursing, Psychotherapy and Community Health, Dublin City University.
Prof Corina Naughton - Researcher Co-applicant - School of Nursing, Midwifery and Health Systems, University College Dublin.
Prof Katie Robinson - Researcher Co-applicant - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, Health Research Board- Trials Methodology Research Network, University of Limerick, Limerick, Ireland.
Dr Elaine Toomey - Researcher Co-applicant - Centre for Health Research Methodology, School of Nursing and Midwifery, University of Galway, Galway, Ireland.
Mr Pa Vaughan - Public patient involvement.
Prof Anne Griffin - Collaborator - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Dr James van Oppen - Collaborator - Emergency Medicine Academic Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
Prof Frances Horgan - Collaborator - School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.
Dr Christine Hayes - Collaborator - School of Medicine, Faculty of Education and Health Sciences, Ageing Research Centre, University of Limerick, Limerick, Ireland.
Dr Aoife Whiston - Collaborator - Department of Psychology, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Prof Molly Manning - Collaborator - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Dr Frank Moriarty - Collaborator - School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and health Sciences, Dublin, Ireland.
Dr Íde O’Shaughnessy - Collaborator - School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Prof Margaret O’Connor - Collaborator - School of Medicine, Faculty of Education and Health Sciences, Ageing Research Centre, University of Limerick, Limerick, Ireland. University Hospital Limerick, Limerick, Ireland.
Dr Stefan Grund - Collaborator - Geriatric Centre at Heidleberg University, Heidleberg, Germany.
Disease Category: Health care of older people
Disease Name: N/A
Age Range: 65 - 120
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Families
- Patient/ support group representatives
- Researchers
- Service commissioners
- Service users
- COS for clinical trials or clinical research
- COS for practice
- Consensus meeting
- Delphi process
- Focus group(s)
- Interview
- Literature review
- Systematic review
The development of the COS will adhere to the Core Outcome Set–STAndards for Development (COS-STAD), and the protocol will be reported in accordance with the Core Outcome Set–STAndardised Protocol Items (COS-STAP) Statement. This study will comprise of 5 stages: (1) an umbrella review to identify outcome domains and measurement instruments reported in systematic reviews of CGA studies; (2) a rapid qualitative evidence synthesis to identify outcomes that matter to older adults; (3) a qualitative study involving older adults, family members, researchers, and healthcare professionals; (4) a real-time Delphi study to prioritise outcomes; and (5) a consensus meeting to agree the final COS and recommend appropriate outcome measurement instruments.