Current evidence on the core components of the geriatric rehabilitation process: a systematic review.

BACKGROUND

Geriatric rehabilitation (GR) is a key component of integrated care for older persons with multimorbidity, yet its fundamental care process and core components that enable effective GR remain poorly defined and highly variable.

METHODS

We conducted a systematic review (Registration ID: PROSPERO 2025 CRD42025642761) to identify and synthesise evidence on core components of the GR care process. Medline, CINAHL, Cochrane and Embase were searched to 31 January 2025. Randomised controlled trials (RCTs) and controlled prospective cohort studies involving multimorbid geriatric patients undergoing multidisciplinary GR programmes were included. Study quality was assessed using the JBI critical appraisal tool.

RESULTS

Thirty-six studies (31 RCTs and 5 controlled prospective cohort studies), comprising 10,647 patients, met the inclusion criteria. Studies represented a broad range of GR service types. Substantial heterogeneity was observed in reported care processes, including terminology, team composition, workflow, contextual factors, and assessment methods, with over 90 different tools used. Comprehensive geriatric assessment (CGA) was rarely reported, patients with moderate to severe dementia were frequently excluded, and no study described the entire GR care process in a holistic manner.

DISCUSSION: Current evidence shows substantial heterogeneity and fragmentation in the description and implementation of the GR care process, with variable depth of implementation, team structures and assessments. The lack of reproducible process structures and clearly defined core components limits comparability, implementation, and evaluation.

CONCLUSION

Future research should adopt study designs spanning the full GR pathway across settings, incorporate standardised process indicators, a toolbox of CGA and goal-setting instruments and evaluate outcomes aligned with the biopsychosocial principles of the ICF.