In older adults seen by liaison psychiatry, frailty outweighed psychiatric variables in predicting early mortality

A multicentre prospective cohort study followed 465 consecutive patients aged 65 and over who were assessed by consultation-liaison psychiatry in ten general hospitals in Spain between January and July 2024 Primary Study (Narvaiza-Grau et al., PMID 42785108). Mean age was 77.4 years. Frailty on the Clinical Frailty Scale was present in 60.2%, 55.8% received a new psychiatric diagnosis (most commonly delirium), and 71.6% were taking psychotropic medication, including antidepressants (49.0%) and benzodiazepines (42.6%). Outcomes were falls, institutionalisation, access to mental-health follow-up, and mortality at one and three months after discharge.

Frailty was independently associated with early mortality, whereas age was the main predictor of mortality between one and three months. Psychotropic polypharmacy was associated with falls. Older age was associated with a lower likelihood of specialist mental-health follow-up. The authors conclude that frailty and medical comorbidity appear to outweigh psychiatric variables in predicting outcomes in this population, and that integrating comprehensive geriatric assessment and medication review into liaison psychiatry may improve care.

The finding is an association in an observational cohort, and the recommendation is the authors’ inference rather than a tested intervention: the study did not evaluate whether adding geriatric assessment or medication review to liaison work changes any outcome. It was conducted in Spanish general hospitals, so service structure and follow-up arrangements will differ from the NHS. For liaison and community psychology services, the practical point is the gap it reports after discharge: older patients were less likely to reach specialist mental-health follow-up, which is a question about community capacity as much as about the hospital consultation. No UK comparator was identified in the source material.