The medical world has adopted the term Comprehensive Geriatric Assessment (CGA) to describe a package of measurable multi-disciplinary investigations and diagnostics. CGAs are conducted for frail people past age 70 to find geriatric syndromes by assessing the patient's overall health including medical, psychiatric and functional abilities. The idea is that CGAs will yield better overall medical management and improve wellbeing, minimize hospital visits, and extend lifespan. CGAs are diagnostic processes, but in practice the term is often used to include both evaluation and health management activities. More people now live to what used to be called an advanced age, so CGAs are valuable.
A CGA team typically includes a clinician (not necessarily a geriatrician), a nurse, an occupational therapist, a physiotherapist, and a social worker. The patient or caretaker may be considered part of the team. A team lead coordinates. The primary care clinician or geriatrician generally initiates the CGA referral, including the patient’s age, chronic or acute health problems (e.g. heart attack, injury), mental disorders (e.g. depression), geriatric disorders (e.g. fall history or functional instability), previous medical history, and any particular change in living (from home to nursing care or from assisted living to isolation).
Five CGA models:
Information technology has made taking a CGA more efficient. Data can be collected from the patient or caregiver electronically, supplemented by traditional means of assessment. CGA teams might send a questionnaire to a patient or caretaker before the office visit. This approach can reduce time and enable collection of detailed information while maintaining the privacy of records.
The components of the CGA questionairre include:
Functional abilities evaluated by the CGA include:
The information the geriatrician or CGA team gathers aid them in the design of a patient-centered integrated care plan to improve quality of life, functional abilities, reduce support dependence, and minimize hospital visits.
The University of Missouri has a webpage summarizing some things evaluated in a CGA.
More people now live to what used to be called an advanced age, so CGAs are valuable.
