Objective:

To examine the impact of integrated care models on health outcomes, functional abilities, cognitive development, and healthcare utilization in older adults with geriatric and cognitive disorders.

Approach:

• Study Design: Retrospective cohort study with propensity score matching and multivariable modeling.
• Population: 2,300 participants aged 65 and above, divided into integrated care (n = 1,110) and standard care (n = 1,190) groups.
• Outcomes Measured: Hospitalization rates, functional decline (ADL and IADL), cognitive decline, mortality rates, and service usage rates over 24 months.

Key Findings:

• High prevalence of geriatric syndromes: 40.0% cognitive impairment, 32.0% frailty, 32.5% depression, 49.0% polypharmacy, and 68.5% multimorbidity.
• High healthcare utilization: 92 hospital admissions and 134 emergency visits per 100 person-years.
• 31.4% experienced functional decline in ADL and 42.7% in IADL.
• Integrated care reduced hospital admissions (IRR 0.78) and 30-day readmissions (OR 0.81), and decreased length of stay by 1.2 days.
• Cognitive decline showed partial protection (MoCA change +0.86; dementia conversion HR 0.71), and mortality decreased (HR 0.76).
• Frailty (OR 2.21) and cognitive impairment (OR 1.42) were strong predictors of functional decline.

Interpretation:

Integrated care models are associated with reduced hospital admissions and delayed cognitive decline while improving patient survival by managing frailty and providing unified treatment.

Limitations:

• Retrospective design may limit causal inferences.
• Potential confounding factors not fully controlled.

Conclusion:

Integrated care models effectively address the complex health needs of older adults.