{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:46:30Z","timestamp":1793295990148,"version":"4.5.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults presenting to emergency departments or acute wards are at increased risk of functional decline, delirium, falls, prolonged hospital stay, and early mortality. Early recognition of vulnerability is crucial for timely preventive interventions, yet specific geriatric assessment is often not performed at admission due to time limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To provide a clinically focused synthesis of short geriatric screening tools and present a practical two-step model linking early screening with targeted clinical action.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This narrative review summarizes brief screening instruments that can be completed within minutes and are suitable for routine use. A targeted literature review identified tools used and evaluated available evidence on predictive accuracy, feasibility, and clinical integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rapid tools such as ISAR, TRST, PRISMA-7, and APOP allow early identification of patients at risk of functional decline, readmission, or short-term mortality. Multidomain instruments, including HARP, SHERPA, and ISAR-HP, provide broader prognostic information, supporting discharge planning and targeted follow-up. Predictive accuracy is generally moderate, with the area under the curve (AUC) typically between 0.60 and 0.70. Clinical impact depends on embedding screening into routine workflows and linking results to actionable interventions such as early mobilization, cognitive assessment, medication review, or referral to geriatric specialists. Clinical integration seems to require a tiered, two-step approach: rapid screening upon admission, followed by a comprehensive multidomain assessment on the ward.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Short geriatric screening tools are essential in acute care. A two-step approach appears to be a practical and clinically reasonable strategy for optimizing early detection and linking screening to targeted interventions. However, further research is needed to validate its effectiveness and define the optimal implementation strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1815638","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:46:59Z","timestamp":1779338819000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid clinical identification of vulnerable older adults in acute and emergency care: narrative review of short geriatric screening tools"],"prefix":"10.3389","volume":"13","author":[{"given":"Danilo","family":"\u010ce\u0161ljarac","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Vascular Diseases, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Lipej","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brina","family":"Skaza","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Spirkoska Mangaroska","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Vascular Diseases, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi\u0161o","family":"\u0160abovi\u010d","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Vascular Diseases, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Er\u017een","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Vascular Diseases, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"B1","volume-title":"Population Structure and Ageing.","year":"2025"},{"key":"B2","unstructured":"Population Ageing in Slovenia.\n          \n          2025"},{"key":"B3","unstructured":"Hospitalisations and Emergency Department Visits among Older Adults.\n          \n          2025"},{"key":"B4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/j.cger.2018.06.006","article-title":"Preventing hospital complications in older patients.","volume":"34","author":"Palmer","year":"2018","journal-title":"Clin Geriatr Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"219","DOI":"10.7326\/0003-4819-118-3-199302010-00011","article-title":"Hazards of hospitalisation of the elderly.","volume":"118","author":"Creditor","year":"1993","journal-title":"Ann Intern Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1056\/NEJM199903043400901","article-title":"A multicomponent intervention to prevent delirium in hospitalised older patients.","volume":"340","author":"Inouye","year":"1999","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1782","DOI":"10.1001\/jama.2011.1738","article-title":"Hospitalisation-associated disability: \u201cShe was probably able to ambulate, but I am not sure\u201d.","volume":"306","author":"Covinsky","year":"2011","journal-title":"JAMA."},{"key":"B8","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.jamda.2018.09.032","article-title":"The course of geriatric syndromes in acutely hospitalised older adults: the Hospital-ADL Study.","volume":"20","author":"van Seben","year":"2019","journal-title":"J Am Med Dir Assoc."},{"key":"B9","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1001\/jamainternmed.2018.5408","article-title":"Exercise intervention in very elderly inpatients: a randomised clinical trial.","volume":"179","author":"Mart\u00ednez-Velilla","year":"2019","journal-title":"JAMA Intern Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype.","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1093\/gerona\/62.7.722","article-title":"Frailty in relation to the accumulation of deficits.","volume":"62","author":"Rockwood","year":"2007","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/acem.12569","article-title":"Risk factors and screening instruments to predict adverse outcomes in older emergency department patients: a systematic review.","volume":"22","author":"Carpenter","year":"2015","journal-title":"Acad Emerg Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1093\/ageing\/afx019","article-title":"Frailty identification in the emergency department\u2014a systematic review focusing on feasibility.","volume":"46","author":"Elliott","year":"2017","journal-title":"Age Ageing."},{"key":"B14","doi-asserted-by":"publisher","first-page":"6280","DOI":"10.3390\/ijerph20136280","article-title":"Diagnostic accuracy of frailty screening instruments validated for use among older adults attending emergency departments: a systematic review and meta-analysis.","volume":"20","author":"Moloney","year":"2023","journal-title":"Int J Environ Res Public Health."},{"key":"B15","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.annemergmed.2010.04.015","article-title":"Older patients in the emergency department: a review.","volume":"56","author":"Samaras","year":"2010","journal-title":"Ann Emerg Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"CD006211","DOI":"10.1002\/14651858.CD006211.pub3","article-title":"Comprehensive geriatric assessment for older adults admitted to the hospital.","volume":"9","author":"Ellis","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"B17","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s41999-021-00505-1","article-title":"European guidelines on geriatric emergency medicine.","volume":"12","author":"Conroy","year":"2021","journal-title":"Eur Geriatr Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s41999-021-00501-5","article-title":"Geriatric emergency care: improving care for older adults in the emergency department.","volume":"12","author":"Carpenter","year":"2021","journal-title":"Eur Geriatr Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1007\/s11739-007-0067-1","article-title":"The elderly in the emergency department: a critical review of problems and solutions.","volume":"2","author":"Salvi","year":"2007","journal-title":"Intern Emerg Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1111\/j.1365-2702.2009.03066.x","article-title":"A systematic review of predictors and screening instruments to identify older hospitalised patients at risk for functional decline.","volume":"19","author":"Hoogerduijn","year":"2010","journal-title":"J Clin Nurs."},{"key":"B21","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1093\/ageing\/afp146","article-title":"Predicting risk of functional decline in older patients admitted to hospital: a comparison of three screening instruments.","volume":"38","author":"Braes","year":"2009","journal-title":"Age Ageing."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1046\/j.1532-5415.2001.49281.x","article-title":"The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community.","volume":"49","author":"Saliba","year":"2001","journal-title":"J Am Geriatr Soc."},{"key":"B23","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.archger.2007.06.004","article-title":"PRISMA-7: a case-finding tool to identify older adults with moderate to severe disabilities.","volume":"47","author":"Ra\u00eeche","year":"2008","journal-title":"Arch Gerontol Geriatr."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1111\/j.1532-5415.1999.tb05204.x","article-title":"Detection of older people at increased risk of adverse health outcomes after an emergency visit: the ISAR screening tool.","volume":"47","author":"McCusker","year":"1999","journal-title":"J Am Geriatr Soc."},{"key":"B25","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.1553-2712.2003.tb01996","article-title":"A brief risk-stratification tool to predict repeat emergency department visits and hospitalisations in older patients discharged from the emergency department.","volume":"10","author":"Meldon","year":"2003","journal-title":"Acad Emerg Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.exger.2018.06.015","article-title":"Optimisation of the APOP screener to predict functional decline or mortality in older emergency department patients.","volume":"110","author":"de Gelder","year":"2018","journal-title":"Exp Gerontol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/j.1532-5415.1996.tb00910.x","article-title":"Hospital Admission Risk Profile (HARP): identifying older patients at risk for functional decline following acute medical illness and hospitalisation.","volume":"44","author":"Sager","year":"1996","journal-title":"J Am Geriatr Soc."},{"key":"B28","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/BF03078117","article-title":"A screening tool to identify older people at risk of adverse health outcomes at the time of hospital admission: the Variable Indicative of Placement risk (VIP).","volume":"37","author":"Vandewoude","year":"2006","journal-title":"Tijdschr Gerontol Geriatr."},{"key":"B29","doi-asserted-by":"publisher","first-page":"327","DOI":"10.33510\/njmed.2014.07.003","article-title":"Risk of adverse outcomes in older emergency department patients: the Variable Indicative of Placement (VIP) at ED presentation.","volume":"72","author":"van Loon","year":"2014","journal-title":"Neth J Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1093\/eurpub\/cki165","article-title":"Early evaluation of the risk of functional decline following hospitalisation of older patients: development of the SHERPA predictive tool.","volume":"16","author":"Cornette","year":"2006","journal-title":"Eur J Public Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e12965","DOI":"10.1002\/emp2.12965","article-title":"The interRAI emergency department screener: a novel instrument for identifying older emergency patients at risk of adverse outcomes.","volume":"4","author":"Mowbray","year":"2023","journal-title":"J Am Coll Emerg Physicians Open."},{"key":"B32","first-page":"169","article-title":"Early identification of the geriatric profile in the emergency department: presentation of the short emergency geriatric assessment (SEGA).","volume":"29","author":"Schoevaerdts","year":"2004","journal-title":"Revue Geriatrie."},{"key":"B33","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1111\/j.1553-2712.2008.00157.x","article-title":"Emergency department case-finding for high-risk older adults: the Brief Risk Identification for Geriatric Health Tool (BRIGHT).","volume":"15","author":"Boyd","year":"2008","journal-title":"Acad Emerg Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s12603-018-1152-z","article-title":"A 10-min targeted geriatric assessment predicts mortality in fast-paced acute care settings: a prospective cohort study.","volume":"23","author":"Aliberti","year":"2019","journal-title":"J Nutr Health Aging."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1240082","DOI":"10.3389\/fmed.2023.1240082","article-title":"Validation of the ICEBERG emergency room screening tool for early identification of older patients with geriatric consultation needs.","volume":"10","author":"Bischoff-Ferrari","year":"2023","journal-title":"Front Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"67","DOI":"10.6890\/IJGE.202601_20(1).0011","article-title":"Screening for geriatric conditions: comparison of FIND-NEEDS, ICOPE-TW, and comprehensive geriatric assessment.","volume":"20","author":"Lee","year":"2026","journal-title":"Int J Gerontol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1007\/s12603-015-0561-6","article-title":"Validity, reliability, and feasibility of tools to identify frail older patients in inpatient hospital care: a systematic review.","volume":"20","author":"Warnier","year":"2016","journal-title":"J Nutr Health Ageing."},{"key":"B38","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.jen.2013.08.014","article-title":"Implementation of the Identification of Seniors at Risk (ISAR) tool in the emergency department using the Plan\u2013Do\u2013Study\u2013Act model.","volume":"40","author":"Asomaning","year":"2014","journal-title":"J Emerg Nurs."},{"key":"B39","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.annemergmed.2025.05.018","article-title":"The prognostic accuracy of frailty and vulnerability screening for older adults in the emergency department: a systematic review and meta-analysis.","volume":"86","author":"Ku","year":"2025","journal-title":"Ann Emerg Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12873-026-01510-1","article-title":"Comparative prognostic performance of identification of seniors at risk tool and national early warning score for 30-day adverse outcomes in older emergency department patients.","volume":"26","author":"Aksu","year":"2026","journal-title":"BMC Emerg Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1186\/s12877-022-03274-2","article-title":"Performance of the APOP-screener for predicting in-hospital mortality in older COVID-19 patients: a retrospective study.","volume":"22","author":"van der Velde","year":"2022","journal-title":"BMC Geriatr."},{"key":"B42","doi-asserted-by":"publisher","first-page":"6685","DOI":"10.3390\/ijerph19116685","article-title":"Validation of screening tools for predicting the risk of functional decline in hospitalised elderly patients.","volume":"19","author":"Wang","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s41999-020-00337-1","article-title":"Geriatric emergency care research in Europe: results from the European Task Force on Geriatric Emergency Medicine.","volume":"11","author":"Mooijaart","year":"2020","journal-title":"Eur Geriatr Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1186\/s12877-018-0985-9","article-title":"The Geriatric Emergency Department Intervention (GEDI) model of care.","volume":"18","author":"Wallis","year":"2018","journal-title":"BMC Geriatr."},{"key":"B45","doi-asserted-by":"publisher","first-page":"afac026","DOI":"10.1093\/ageing\/afac026","article-title":"The impact of a geriatric emergency department intervention on patient and system outcomes: a quasi-experimental study.","volume":"51","author":"Marsden","year":"2022","journal-title":"Age Ageing."},{"key":"B46","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1111\/jgs.18594","article-title":"Automating risk stratification for geriatric syndromes in the emergency department.","volume":"72","author":"Haimovich","year":"2024","journal-title":"J Am Geriatr Soc."},{"key":"B47","doi-asserted-by":"publisher","first-page":"ooad021","DOI":"10.1093\/jamiaopen\/ooad021","article-title":"Use of the electronic medical record to screen for high-risk geriatric patients in the emergency department.","volume":"6","author":"Saxena","year":"2023","journal-title":"JAMIA Open."},{"key":"B48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17294\/2694-4715.1041","article-title":"Examination of geriatric care processes in accredited geriatric emergency departments.","volume":"4","author":"Santangelo","year":"2023","journal-title":"J Geriatr Emerg Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.annemergmed.2021.08.001","article-title":"Geriatric emergency department innovations: results from implementation studies.","volume":"80","author":"Hwang","year":"2022","journal-title":"Ann Emerg Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.annemergmed.2021.06.013","article-title":"Reach and adoption of a geriatric emergency department accreditation program in the United States.","volume":"79","author":"Kennedy","year":"2022","journal-title":"Ann Emerg Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1111\/acem.14776","article-title":"Implementation of geriatric screening in the emergency department using the Consolidated Framework for Implementation Research.","volume":"30","author":"Southerland","year":"2023","journal-title":"Acad Emerg Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/acem.14665","article-title":"Dissemination and implementation of age-friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals.","volume":"30","author":"Hwang","year":"2023","journal-title":"Acad Emerg Med."}],"updated-by":[{"DOI":"10.3389\/fmed.2026.1898845","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000}}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1815638\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:30:15Z","timestamp":1782747015000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1815638\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":52,"alternative-id":["10.3389\/fmed.2026.1815638"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1815638","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"article-number":"1815638"}}