Caring for older adults with mental health conditions including neurocognitive conditions is complex. Clinical practice guidelines (CPGs) are intended to improve care for such conditions in older adults. This scoping review sought to systematically identify, synthesize, map evidence and identify the gaps in implementation strategies used in the implementation of CPGs for mental health conditions in older adults including neurocognitive conditions. This scoping review was conducted using the JBI Manual for Evidence Synthesis methods for scoping reviews. Six research databases (Ageline, MEDLINE, Cochrane Library, EMBASE, PsycINFO, JBI EBP) and grey literature were searched. Inclusion criteria for the articles were adults 65 and older and focused on older adults mental health and neurocognitive conditions. Strategies to the implementation of CPGs were categorized using the Effective Practice and Organization of Care (EPOC) framework. A total of three articles were identified in this scoping review. Reported implementation strategies were tailored to providers, were educational, and interdisciplinary collaboration. CPGs length, perceived weakness of evidence, and providers’ perception of relevance to patients were noted as challenges to implementing CPGs. Our search results demonstrated a paucity of literature with only three peer reviewed studies located. Despite the limited available literature, this review contributes to guideline to practice gap literature by synthesizing and identifying potentially effective implementation strategies. We make recommendations about how to potentially improve adherence to clinical practice guidelines that could be implemented by researchers, healthcare providers, and health systems policy decision makers to improve our healthcare systems.

Unpaid caregivers face significant health challenges due to the sustained demands of their roles. Social prescribing is a model of care that may help unpaid caregivers connect with non-medical community-based support systems to improve their health and well-being. Given the growing interest in social prescribing, there is a need to map out existing literature to understand its potential to support caregiver health. This scoping review describes the current landscape of social prescribing programs for unpaid caregivers. A protocol was previously published on Open Science Framework. We searched academic and grey literature from January 2000 to March 2025, following Arksey and O'Malley's framework and JBI recommendations for scoping reviews. An inductive approach was used to analyse data in order to generate descriptive summaries and themes of program and outcome characteristics. We identified 17 studies for inclusion from 4376 titles and abstracts. Most programs were designed for both caregivers and care recipients to participate in together and involved a variety of self, provider and community-based referral pathways. Programs included nature, art, museum and physical activity-based experiences, and most were facilitated by a supervisor or coach. Program features varied, offering caregivers spaces to connect and socialize, strengthen their relationship with the care recipient, or express themselves creatively. Studies reported positive impacts on caregiver stress, the caregiver-care recipient relationship, and social connection. Logistical benefits such as low cost and accessibility, as well as challenges like transportation and scheduling were reported to influence program attendance and retention. While this review highlights the potential of social prescribing to support caregiver health, future research should explore opportunities to integrate programs within respite care, develop more structured referral pathways and evaluate the full social prescribing pathway in addition to virtual programming options to ensure effective implementation within broader health and social care systems.

The emotional experience of informal caregiving is considerable and complex, consisting of tensions internally and with the care recipient, and exacerbated by pressures to adopt the caregiver role without complaint or assistance. Our findings demonstrate the need to develop policies to relieve distress for caregivers of fragility fracture patients. Informal caregiving can have considerable physical and psychosocial consequences, with the emotional strain of caregiving considered most distressing. Few studies have examined the emotional experience of caregiving for individuals with a fragility fracture or the contextual factors that may influence this experience. We aimed to explore the experience of caring for someone after a fragility fracture to understand the nuances of the emotional experience and identify ways to better support informal caregivers in the future. We used a phenomenological approach to examine caregivers’ experiences. We recruited primary caregivers of patients discharged from a rehabilitation hospital following a fragility fracture. We conducted individual interviews with caregivers and analyzed the data phenomenologically to describe the structure of caregivers’ emotional experiences and illuminate potential influencing factors. We interviewed 32 caregivers (19 females, 13 males; 37–95 years old). We found that the emotional experience of caregiving was complex, consisting of tensions internally and with care recipients, and exacerbated by multiple pressures to adopt the caregiver role. As a result of these pressures, caregivers often felt reluctant to voice displeasure or ask for help, exacerbating their burden and reinforcing a sense that they must suffer in silence. Our study demonstrates the multifaceted nature of caregivers’ emotional burden and highlights the pressures felt by caregivers of fragility fracture patients to take on caregiving roles without complaint or assistance. Our findings highlight the need to acknowledge the emotional complexity of caregiving, empower caregivers to ask for help, and develop meaningful supports and policies to alleviate caregiver burden.

Approximately 30% of all older adults fall every year, contributing to major healthcare costs. Although high quality evidence suggests exercise can prevent falls, we do not know the contextual factors influencing their delivery. Our work aims to better understand the context of service delivery from the perspective of organizational representatives in Ontario to inform future interventions that improve the dissemination and implementation of evidence-based exercise services in the community. We conducted a qualitative description by performing interviews with representatives of organizations that deliver fall prevention exercise services in Ontario. We informed our semi-structured interview guide using the Consolidated Framework for Implementation and conducted a thematic analysis from a post-positivist perspective. We found that organisations delivered exercise in three ways: (1) kinesiologists to support trained instructors; (2) hiring kinesiologists to provide exercise services directly; or (3) outsourcing providers with varying qualifications (such as kinesiologists, personal trainers, or yoga instructors). We also present three major themes: funding, capacity, and location were key concerns that limited access to services; networking between organizations existed and was perceived as helpful; and good intentions but major roadblocks to collaboration. In conclusion, funding, location, and capacity shape service delivery in Ontario, limiting provider access and space availability. While networking helps, barriers influence the ability for organizations to collaborate with other organizations. Future research should explore more innovative funding models and organization context in more detail, especially for rural service providers.

BACKGROUND:Approximately 30% of older adults (≥65) fall annually, yet community delivery of evidence-based fall prevention exercise remains poorly understood. This qualitative study explores fall prevention exercise service delivery from the perspective of exercise providers in Ontario. METHODS:We conducted semi-structured interviews with 20 exercise providers, guided by the Consolidated Framework for Implementation Research, and analyzed data thematically. FINDINGS:While providers valued evidence-based balance and functional training, those in large-group settings struggled with exercise tailoring and progression. Instead, many prioritized building trust, creating safe environments, and facilitating socialization. BARRIERS WERE HIGHLY CONTEXTUAL:kinesiologists lacked resources, independent providers lacked networking, and municipal/non-profit staff faced low pay and organizational competition. DISCUSSION:To enhance implementation of fall prevention exercise services, support must address unique contextual barriers while balancing clinical tailoring with participant adherence. Our insights suggest that leveraging existing community services and focusing on provider-specific supports are essential for effective implementation of fall prevention exercise services in Ontario.

CLINICAL IMPACT RATINGS:Geriatrics:[Formula: see text] Rheumatology:[Formula: see text].

BACKGROUND: Home care supports older adults living in the community by providing medical, rehabilitative, and personal care at home. Across Canada there is wide variability in public funding models for home care, which may also be paid for privately. Our objective was to compare individual characteristics across different home care payment groups and examine associations between sociodemographic factors, health status, and private payment for care. METHODS: We included formal home care users from the Canadian Longitudinal Study on Aging (CLSA) between 2015 and 2021 and classified them into three groups based on how much of their home care was paid for out-of-pocket: none, part, or all. We used descriptive statistics to compare the individual and home care characteristics of the three groups. We used unadjusted and adjusted multinomial logistic regression models to examine associations with the home care payment groups. RESULTS: Of 44,817 participants in the CLSA, 3,580 were formal home care users. Using weighted proportions, 6.8% of the CLSA were home care users, and of these 46.2% reported paying nothing out-of-pocket, 12.7% paid partially, and 41.0% paid all costs. Individuals who paid all costs reported the best health, whereas those who paid partially reported the worst. Meal preparation/homemaking and housework/maintenance services were more commonly paid for privately, while medical care was more likely to be publicly funded. Higher-income individuals were more likely to pay entirely out-of-pocket and large provincial variations were noted across payment groups. CONCLUSIONS: Private home care is common in Canada, particularly for non-medical services. Income-related disparities may limit access for those unable to pay, contributing to inequities in aging. Policies ensuring equitable access to essential services will be critical as demand for home care grows.

OBJECTIVE:To describe and compare the factors that impact initial rehabilitation type after hip fracture surgery. DESIGN:Retrospective population-based cohort study. SETTING AND PARTICIPANTS:People aged between 50 and 105 with a hip fracture who had a surgical repair in Ontario, Canada, between January 1, 2015, and December 31, 2021. METHODS:Descriptive statistics and a multinomial logistic regression model were used to identify factors associated with initial rehabilitation type. RESULTS:In this study, 63,401 individuals were included with a mean age of 80 years [standard deviation (SD) 10.9], mostly female (67.3%), with 86.3% living in urban areas at the time of hospitalization and most (72.6%) admitted from the community without home care. A total of 24.5% of individuals did not receive any form of rehabilitation. Rurality of residence decreased the odds of having an initial rehabilitation type in complex continuing care [odds ratio (OR), 0.23; 95% CI, 0.21-0.26], in inpatient rehabilitation (OR, 0.26; 95% CI, 0.24-0.28), or in community rehabilitation (OR, 0.54; 95% CI, 0.50-0.58) compared with no rehabilitation. Dementia decreased the odds of having an initial rehabilitation type in complex continuing care (OR, 0.75; 95% CI, 0.69-0.81), in inpatient rehabilitation (OR, 0.44; 95% CI, 0.41-0.47), or in community rehabilitation (OR, 0.88; 95% CI, 0.82-0.95) compared with receiving no rehabilitation. Previous history of fragility fracture decreased the odds of having an initial rehabilitation type in either complex continuing care (OR, 0.30; 95% CI, 0.27-0.34), in inpatient rehabilitation (OR, 0.27; 95% CI, 0.24-0.29), or in community rehabilitation (OR, 0.33; 95% CI, 0.30-0.37) compared with no rehabilitation. CONCLUSIONS AND IMPLICATIONS:Rurality of residence, dementia, and previous history of fragility fractures reduced the odds of receiving specialized inpatient rehabilitation and increased the odds of receiving no rehabilitation. Future research should focus on achieving more equitable care for individuals living in rural settings, with dementia, or with previous fragility fractures to enhance the quality of care and achieve best outcomes for the overall hip fracture population.

OBJECTIVE:To assess the comparative efficacy of interventions on depressive symptoms and disorders in older adults living in long-term care (LTC). DESIGN:Systematic review and network meta-analysis. SETTING AND PARTICIPANTS:Older adults living in LTC or equivalent settings. METHODS:We searched 6 electronic databases and gray literature sources to identify randomized controlled trials describing pharmacologic or nonpharmacologic interventions. Studies had to measure depression as an outcome in persons living in LTC. Study inclusion and study quality were assessed in duplicate. Population characteristics, descriptions of intervention and control treatments, and end-point depression outcomes for each treatment were extracted from included studies. A network meta-analysis using the standardized mean difference (SMD) of depression scores was completed using a random effects model. RESULTS:A total of 182 studies were included in the review. The network meta-analysis was completed with 147 studies and included 31 treatment conditions. Compared with usual care, horticulture therapy (SMD, -6.85; 95% Credibility Interval, -8.49 to -5.22) and cognitive behavioral therapy (SMD, -1.98; 95% Credibility Interval, -2.91 to -1.05) were the most efficacious treatments. Animal therapy, group reminiscence therapy, multicomponent nonpharmacologic treatments, exercise, and socialization interventions also significantly improved depressive symptoms compared with usual care. CONCLUSIONS AND IMPLICATIONS:Many nonpharmacologic treatments for depression in LTC have been studied and are found to be efficacious. The low-risk and cost-effective nature of many of the nonpharmacologic treatments makes them ideal for use in LTC. More studies of pharmacologic treatments are needed to inform prescribing for depression in the LTC population. The range of treatments available for depression may help clinicians select therapies individualized to resident needs.

Majority of long-term care (LTC) residents experience cognitive impairment and behavioral and psychological symptoms of dementia (BPSD). Managing BPSD in LTC is often sub-optimal and variable, resulting in inappropriate use of psychotropic medications and under-utilization of non-pharmacological interventions. We developed and tested an Integrated Care Pathway (ICP) that combines pharmacological and non-pharmacological approaches for BPSD using a measurement based-care approach in select psychiatry inpatient units and LTCs. We now aim to implement and evaluate the ICP combined with technology-based monitoring systems and interventions (Tech-ICP) in LTCs using pragmatic trial design. Tech-ICP is a technology-driven solution that integrates assessment tools, monitoring systems, and algorithmic treatment based on ICP principles. It includes dashboards for the clinicians, wearable devices for biometric monitoring, and virtual reality (VR) interventions such as personalized reminiscence therapy and simulation-based experiential learning for staff. We aim to implement the Tech-ICP at 40 LTCs affiliated with academic hospitals across Toronto over three-years in a step wedge design. The implementation will involve three phases, readiness assessment, implementation, and transition to sustainability. We will collect outcomes related to effectiveness of implementation, and site and individual level data related to clinical outcomes. The project will be co-led by persons with lived experience to ensure alignment with priorities of LTC residents and caregivers. This study will provide important insights regarding implementation of a clinical intervention for management of BPSD in LTC and its evaluation using pragmatic trial design. It is expected that the Tech-ICP will enhance clinical team capabilities through technology to effectively treat BPSD, reduce inappropriate psychotropic medication use, improve quality of life of LTC residents, and reduce caregiver burden burnout. It is also expected to reduce rate of emergency room visits and hospital admissions for LTC residents. Tech-ICP aims to provide a sustainable care model for managing BPSD in LTC's by integrating state of the art technological interventions. This approach is expected to improve care quality by ensuring appropriate use of non-pharmacological and medications, and enhance the overall well-being of both LTC residents and their caregivers. It will also inform design of future pragmatic trials in this population.

BACKGROUND:Small studies have reported associations between first-generation antihistamines and delirium. It is unclear whether first-generation antihistamines cause clinically important delirium among older adult inpatients. OBJECTIVE:To estimate the association between inpatient physician prescribing of first-generation antihistamines and delirium among older general medicine inpatients. METHODS:Cross-sectional study using the GEMINI database of inpatient admissions between April 1, 2015, and March 31, 2022, across 17 hospitals in Ontario, Canada, among people aged 65 years and older. The main exposure was the proportion of attending physicians' admissions by quartile that included a first-generation antihistamine prescription. The primary outcome was inpatient delirium identified using a machine learning tool. We estimated the association between attending physicians' first-generation antihistamine prescribing rate and individual inpatients' risk of delirium using multivariable mixed-effects logistic regression. RESULTS:Among 328,140 inpatient admissions to 755 physicians, 11,507 (3.5%) admissions included a first-generation antihistamine prescription. Physicians in the lowest quartile prescribed a first-generation antihistamine during 2.1% of admissions compared to 5.4% of physicians in the highest quartile. Delirium occurred in 32.3% of admissions to the lowest-prescribing quartile and 36.6% of the highest-prescribing quartile of physicians. In adjusted analyses, every 1% absolute increase in first-generation antihistamine prescribing was associated with 8% increased odds of delirium (aOR: 1.08, 95% CI: 1.05-1.10). Patients admitted to physicians in the highest quartile had 41% increased odds of delirium compared to the lowest quartile (aOR: 1.41, 95% CI: 1.28-1.56). CONCLUSIONS:Older adults admitted to physicians who prescribe first-generation antihistamines more commonly were more likely to experience delirium in the hospital.

Older patients frequently experience delays in discharge post-hip fracture surgery. Our study aimed to describe the sociodemographic and clinical characteristics of patients who had a surgical repair for a hip fracture and to examine the associations between these characteristics and delayed discharge (> 6 days post-surgery) for frail vs. non frail patients. We conducted a retrospective population-based cohort study using routinely collected health administrative data housed at ICES. The study population included all individuals aged 50 to 105 years with a hip fracture who had a surgical repair in Ontario, Canada between January 1, 2015, and December 31, 2021. We used descriptive statistics and multivariable logistic regression models to characterize the association of patient socio-demographics, baseline health, and characteristics of the acute care episode with delayed discharge between non-frail and frail groups. We included 74,838 patients, with a mean age of 80.9 (SD 10.7) years, among which 37,234 (49.8

In March 2024, the Canadian Coalition for Seniors Mental Health launched the Clinical Practice Guidelines (CPG) on the Assessment and Management of BPSD. The goal of our dissemination strategy over the subsequent nine months was to raise awareness of the CPG and enhance healthcare providers' understanding and application of its good practice principles and key recommendations. The primary objective of this poster is to present and evaluate our dissemination strategies. Our knowledge translation approach utilized three strategies in English and French. Diffusion activities required minimal customization and included social media posts on LinkedIn, X, Facebook, announcements on CCSMH website, and press releases. Dissemination activities were tailored to audiences including seven scientific conferences, several webinars, and open-access publications. Application strategies were tailored to participants, such as academic education and training sessions. Evaluation measured cumulative reach of combined activities and synthesized participant feedback. Diffusion efforts reached approximately 29,481 individuals. The CCSMH website recorded nearly 12,000 visitors, with over 7,800 downloads of the CPG in English and French. Dissemination activities introduced the CPG through English and French webinars, which accumulated over 11,200 views, seven conference presentations attended by more than 900 participants, and open-access publications. Additionally, over 800 printed copies were distributed. Application strategies included seven academic education and training initiatives, including the 10-week Project ECHO (Extension of Community Health Outcomes) Care series with over 500 participants, grand rounds at Canadian hospitals and specialty clinics, academic detailing using case studies at conferences, a specialized virtual geriatrics course, and ongoing correspondence with end users. Overall, these knowledge translation activities reached approximately 42,200 individuals. Participant feedback will be presented as graphs. Feedback highlighted the need for scalable implementation strategies, such as developing clinical summaries in electronic and print formats in both English and French. Our findings emphasize the value of tailored dissemination strategies that engage healthcare providers where they seek evidence-based information (relevant websites and social media platforms), gather (scientific conferences), and learn (education series and grand rounds). Effective dissemination of the CPG was crucial for the rapid translation of research evidence into actionable recommendations in the assessment and management of BPSD.

Behavioural and psychological symptoms in dementia (BPSD) are common, can be distressing for persons living with dementia (PLWD), and challenging for caregivers and clinicians. There are few updated clinical practice guidelines available to assist clinicians with the assessment and management of BPSD, including deprescribing of medications. The Canadian Coalition for Seniors’ Mental Health (CCSMH) developed Canadian clinical practice guidelines on the assessment and management of BPSD to address these needs. We used the Guideline International Network process for development of the BPSD guidelines. A multidisciplinary guideline panel was formed including representatives from geriatric psychiatry, geriatric medicine, family medicine, nursing, pharmacy, and psychology. Surveys identified priority topic areas for the guidelines. A review of existing guidelines, systematic reviews and primary evidence reviews was undertaken to identify evidence to create the guideline recommendations. The guideline panel members framed guideline questions using the PICO format (patient, intervention, comparator, and outcome). Guideline recommendations were created using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) tool and assigned a strength of recommendation (strong or conditional) and quality of evidence (high, moderate, low, and very low). The final guideline recommendations were voted on by the guideline panel with consensus considered to be 80% agreement. The guideline panel met a total of 14 times. A total of 74 recommendations reached consensus and were included in the guideline. These included recommendations on general principles of BPSD assessment and management, BPSD diagnosis, detection, and pharmacological and non-pharmacological management of BPSD syndromes. The following topic areas and recommendations per topic were: general principles of BPSD assessment and management (n = 11), agitation (n = 30), psychosis (n = 5), depression and depressive symptoms (n = 13), anxiety (n = 6), sexual expressions with associated risk (n = 4), and deprescribing (n = 5). The CCSMH Canadian Guidelines on the Assessment and Management of BPSD provide healthcare providers with recommendations based on current evidence from a Canadian context. These guidelines will help inform care for the growing number of people living with dementia who may be affected by BPSD.

Family and friend caregivers of people with dementia (PwD) experience high distress, but have minimal access to support beyond education. Understanding interventions’ comparative efficacy at improving their mental health is critical. We searched MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO, and grey literature from inception until June 13, 2024, for randomized trials (RCTs) comparing any intervention to usual care or other interventions for improving quality of life, burden, distress, or depression or anxiety symptoms in PwD's family or friend caregivers. Independent reviewer pairs conducted study screening, data abstraction, and risk of bias appraisal. We derived standardized mean differences from random-effects network meta-analysis; back-transformed mean differences (MD) on the World Health Organization Quality of Life Scale (psychological health), Zarit Burden Interview, Neuropsychiatric Inventory (distress), Center for Epidemiologic Studies Depression Scale, and Hospital Anxiety and Depression Scale (anxiety) to describe quality of life, burden, distress, and depression and anxiety symptom changes, respectively; and probabilities of exceeding each scale's minimum important difference (pMID). We included 196 RCTs (83 interventions; 27,210 caregivers); 63.8% were at high risk of bias from missing data. Compared to education, psychotherapy (MD 17.4, 95% credible interval 3.5 to 31.7; pMID 95.1%) improved quality of life; education+training (-6.4, -12.2 to -0.9; 57.8%) and caregiver/PwD exercise (-13.1, -26.2 to -0.2; 85.9%) improved burden; mindfulness (-8.3, -12.9 to -3.9; 97.6%) and case management+education (-6.9, -13.0 to -0.3; 82.7%) improved distress; education+psychotherapy+support (-35.3, -44.8 to -25.5; 100%), education+training (-4.0, -6.2 to -1.7; 42.9%), education+psychotherapy (-11.8, -21.0 to -2.6; 94.4%), mindfulness (-5.1, -9.0 to -1.1; 66.4%), caregiver/PwD education (-23.4, -35.9 to -9.9; 99.6%), respite care+education+support (-23.1, -40.2 to -5.5; 98.2%), education+training+perspective-taking (-10.6, -20.7 to -0.6; 89.6%), and education+journaling+psychotherapy (-7.0, -12.9 to -1.3; 83.5%) improved depressive symptoms; and education+training+psychotherapy (-2.2, -3.7 to -0.8; 81.4%), education+support+training (-3.1, -5.6 to -0.7; 89.0%), exercise+meditation (-5.9, -9.2 to -2.7; 99.4%), cognitive behavioural therapy+support (-15.4, -19.6 to -11.1; 100%), caregiver/PwD counselling (-2.6, -5.2 to -0.1; 79.8%), and education+support+psychotherapy (-7.2, -9.8 to -4.6; 100%) improved anxiety symptoms. Intervention combinations, with or without education, were more efficacious than education alone at improving mental health of PwD's family and friend caregivers.

In Canada, approximately 730,000 people are currently living with dementia. Over 75% will experience behavioural and psychological symptoms of dementia (BPSD). There is a lack of consensus on best practices for the assessment and management of BPSD. In 2024, the Canadian Coalition for Seniors Mental Health (CCSMH) developed a Clinical Practice Guideline (CPG) for assessing and managing BPSD, specifically for agitation, depression, anxiety, psychosis, and sexual expressions of potential risk, and deprescribing antipsychotics and psychotropic medications. Development of the BPSD CPG followed the Guideline International Network (GIN)-McMaster Guideline Development checklist. The guideline is intended for people living with dementia, caregivers of people living with dementia, and health-care providers in community, outpatient, inpatient, long-term care, and other residential care settings. Recommendations were informed by a Canada-wide prioritization exercise to identify CPG topics and preferred terms for describing BPSD. A systematic review of existing dementia CPGs, an overview of systematic reviews on assessing and managing BPSD, and systematic reviews of tools for measuring psychosis, anxiety, and depressive symptoms in people living with dementia was undertaken, along with a rapid review of studies of pharmacologic and nonpharmacologic interventions for reducing sexual expressions of potential risk in people living with dementia. Guideline panel members voted on recommendation strength and quality of evidence, per the Grading of Recommendations, Assessment, Development, and Evaluations approach. This CPG resulted in 11 good practice statements and 63 guideline recommendations that will inform BPSD best practices in a Canadian health-care context.

Background:Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood. Methods:We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA. Results:A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93). Conclusions:Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.