The role of comprehensive geriatric assessment in older patients affected by knee osteoarthritis: an exploratory randomized controlled trial

Nicola Veronese; Anna Fazzari; Eleonora Santangelo; Candela Iommi; Pinar Soysal; Carlo Custodero; Lena Pickert; Maria Cristina Polidori; Nicoleta Stolniceanu; Helena Michalkova; Eva Topinkova; Alberto Pilotto; Mario Barbagallo

doi:10.1007/s40520-025-03061-0

The role of comprehensive geriatric assessment in older patients affected by knee osteoarthritis: an exploratory randomized controlled trial

Aging Clin Exp Res. 2025 May 16;37(1):155. doi: 10.1007/s40520-025-03061-0.

Authors

Nicola Veronese^{1

2}, Anna Fazzari³, Eleonora Santangelo³, Candela Iommi³, Pinar Soysal⁴, Carlo Custodero⁵, Lena Pickert⁶, Maria Cristina Polidori^{6

7}, Nicoleta Stolniceanu⁶, Helena Michalkova⁸, Eva Topinkova^{8

9}, Alberto Pilotto^{10

11}, Mario Barbagallo³

Affiliations

¹ Unit of Geriatrics, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy. nicola.veronese@unipa.it.
² Faculty of Medicine, Saint Camillus International University of Health Sciences, Rome, Italy. nicola.veronese@unipa.it.
³ Unit of Geriatrics, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
⁴ Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Street, 34093, Fatih, Istanbul, Turkey.
⁵ Department of Precision and Regenerative Medicine and Ionian Area (DiMePrev-J), Clinica Medica "Augusto Murri", University of Bari Aldo Moro, Bari, Italy.
⁶ Aging Clinical Research, Department II of Internal Medicine, Center for Molecular Medicine Cologne, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany.
⁷ Cologne Excellence Cluster on Cellular Stress Responses in Ageing-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
⁸ Department of Geriatrics and Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.
⁹ Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic.
¹⁰ Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy.
¹¹ Research, Development and Scientific Coordination Unit, National Reference, High Specialization Hospital, E.O. Galliera Hospitals, Genoa, Italy.

Abstract

Objectives: This study aimed to assess the effectiveness of Comprehensive Geriatric Assessment (CGA) compared to standard of care in improving pain, physical function, and stiffness in older adults with knee osteoarthritis (OA) over six months. Secondary outcomes included multidimensional frailty and quality of life.

Design: An exploratory, multicentre, randomized controlled trial (RCT).

Setting: Five European geriatric centres in Italy, Germany, Turkiye and the Czech Republic.

Participants: Seventy older adults (mean age 76.1 ± 6.8 years; 80% female) with knee OA (Kellgren-Lawrence Grades 1-2) were randomized into two groups: CGA (n = 35) or standard of care (n = 35).

Intervention: The CGA group underwent a multidimensional geriatric assessment and intervention, identifying impairments and tailoring interventions accordingly, while the control group received standard of care.

Main outcome measures: The primary endpoint was improvement in pain, stiffness, and functional limitations measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) over six months. Secondary outcomes included changes in multidimensional frailty (Multidimensional Prognostic Index, MPI), quality of life (SF-36), and adherence to interventions.

Results: The CGA group showed a non-significant improvement in total WOMAC scores (-4.49 ± 3.40, p = 0.19), with slight reductions in pain (-1.12 ± 0.96) and functional limitations (-3.26 ± 2.21). MPI slightly improved (-0.02 ± 0.04, p = 0.69), but no significant changes were observed in SF-36 scores. No falls, hospitalizations, or severe adverse events were reported.

Conclusions: CGA may offer potential benefits for managing knee OA in older adults, particularly for pain and function, though statistical significance was not achieved. Larger studies with longer follow-up are warranted to confirm these findings.

Trial registration: ClinicalTrials.gov Identifier: NCT05659979.

Keywords: Comprehensive geriatric assessment; Disability; Multidimensional; Osteoarthritis; Pain.

Publication types

Randomized Controlled Trial
Multicenter Study

MeSH terms

Aged
Aged, 80 and over
Female
Geriatric Assessment* / methods
Humans
Male
Osteoarthritis, Knee* / diagnosis
Osteoarthritis, Knee* / physiopathology
Osteoarthritis, Knee* / therapy
Quality of Life

Associated data

ClinicalTrials.gov/NCT05659979