1. Introduction
With regard to the gradual improvements in the provision of health services, life expectancy has increased, which has resulted in an increase in the percentage of the older population. According to available statistics, older people in comparison to other age groups are examined five or seven times by doctors. More than 60% of medical expenses are spent for older people [4]. Therefore, it is proposed that there should be a fundamental change in the provision of health care for older population. In Iran, the comprehensive health care program for older adults is included. In this model, the minimum risk factors and clinical symptoms are applied to detect early disease identification, referral and appropriate treatment [7]. The purpose of this study was to investigate the effectiveness of Integrated and Comprehensive Geriatric Care Program of Ministry of Health on Physical and Mental Health of Older Adults in Golestan Province, 2019. 
2. Materials and Method
This was a historical cohort study that was conducted in 2019. This province is located on the North-East of Iran, according to the last census in 2016, the percent of older individuals aged at 60 and over both in rural and urban regions is 7.81. 
Data collection was carried out from 25 March to 14 may 2019. Five hundred health electronic records from 130 comprehensive rural health centers were selected by stratified multi-stage cluster random sampling method. First of all, thirteen centers were randomly selected from 130 comprehensive rural health care. Then, health electronic records that had at least two follow-up examinations about blood pressure, mental health and body mass index from 2016 to 2019 were randomly reviewed. Data analyses were conducted using IBM SPSS v. 20. The statistical tests including repeated measure ANOVA, paired t-test and Wilcoxon were used. 
3. Results 
Five-hundred E-Health Records were evaluated. The Mean±SD age of participants was 69.97±7.45 which was ranged from 60 and 108 year-old. The majority of candidates were women (n=317, 63.4%). Approximately, 56 per cent of participants were housewife whereas the only 1 per cent of candidates were unemployment. Most participants had informal education (n= 370, 74%). In term of marital status, 72.8 per cent of participants were married. The majority of participants were Fars. 
The data related to Health indicators was not appropriate. There was contradictory between systolic and diastolic blood pressure indicators at the first and third stage, the percentage of these indicators were 94% and 21.8%, respectively Table 1.


Indicates the health indicators based on blood pressure, weight, height and depression. 
The lowest percent was related to depression records (1 per cent at the third stage). Repeated measure ANOVA result of systolic blood pressure revealed that there was significant differences among three stages (P<0.01, F=7.44), whereas in terms of diastolic blood pressure there was not any significant difference among three stages (P>0.05, F= 1.7) Table 2.


Demonstrates the results of Repeated measure ANOVA on systolic and diastolic blood pressure. 
The paired-T test highlighted that no significant differences was identified between body mass index at the first and the second phase (P>0.05, t= -0.12). Figure 1 and 2 present the estimated marginal means of systolic and diastolic blood pressure at three phases, and there was a clear trend of decreasing systolic blood pressure (Figure 1).  The paired-T test highlighted that no significant differences was identified between body mass index at the first and the second phase (P>0.05, t= -0.12) Table 3.


Reveals the result of paired-T test on body mass index. The Mean±SD related to depression indicator (DGS11) for the first and the second phase were 1.56±2.12 and 2.05±2.52, respectively. Wilcoxon test did confirm a significant differences between the mean score of depression at the first and second phases (P<0.05).
4. Discussion and conclusion
 Information related to three stages of health care follow-up were not complete. For instance, the researcher did not access to data related to the third stage of care assessment on depression and body mass index. The results of the current study indicated that the implementation of comprehensive health care program in golestan province was able to successfully screen and assess older adults on blood pressure but has not been successful in screening metal health (depression) and body mass index. 

Ethical Considerations
Compliance with ethical guidelines
The study was approved by the Research Committee of University of Social Health and Rehabilitation Sciences (Code: IR.USWR.REC.1397.109).

Funding
This study was supported by Research Center of University of Social Health and Rehabilitation Sciences.

Authors' contributions
All author contributed equally in preparing this article 

Conflicts of interest
The authors declare no conflict of interest 

Acknowledgements
We would like to express our special thanks of gratitude to Health Care Staffs of Golestan Province who cooperated us in this project. 



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