Narrative review of short geriatric screening tools in acute care settings

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Frontiers in Medicine Published May 21, 2026 Medically reviewed May 21, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider a two-step geriatric screening approach in acute care, noting tools have moderate predictive accuracy.

This is a narrative review of short geriatric screening tools for older adults presenting to emergency departments or acute wards. The scope covers tools such as ISAR, TRST, PRISMA-7, APOP, HARP, SHERPA, and ISAR-HP, and their use for predicting outcomes including functional decline, delirium, falls, prolonged hospital stay, early mortality, readmission, predictive accuracy, feasibility, and clinical integration.

The authors synthesize that the predictive accuracy of these tools is generally moderate, with an AUC typically between 0.60 and 0.70. They argue that a two-step approach, involving rapid screening upon admission followed by a comprehensive multidomain assessment, appears to be a practical and clinically reasonable strategy for acute care.

Key limitations noted by the authors include that further research is needed to validate effectiveness and define an optimal implementation strategy. The review does not report specific study populations, sample sizes, or adverse event data.

Practice relevance is restrained; the authors suggest these tools are essential in acute care, but their integration requires careful consideration of local context and resources.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundOlder 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.AimTo provide a clinically focused synthesis of short geriatric screening tools and present a practical two-step model linking early screening with targeted clinical action.MethodsThis 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.ResultsRapid 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.ConclusionShort 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.