Comprehensive Geriatric Assessment

Comprehensive geriatric assessment (CGA) is a team-based multidimensional approach to address the multiple domains of health in older people. CGA involves an interdisciplinary or multidisciplinary team intended to assess health disorders, tailored to each older individual and the setting. Domains addressed included physical and mental health, prevention and management of acute or chronic illness, and screening for disorders, function, and quality of life, taken in conjunction with patient safety and socioeconomic and environmental factors. CGA differs based on the stage of life, overall context of health status, life expectancy, and setting. Attention is paid to psychosocial issues, implementation of advance directives, medication review and reconciliation, and deprescribing of medications; equally vital is the need to address caregiver support and burden. Compared to usual care, CGA has been beneficial in hospital settings with positive effects for personal and operational outcomes and increases the overall likelihood of being alive, living at home and avoiding institutionalization. Current practice guidelines address preventive approaches such as screening for several disorders common in the old but are inconsistent based on the source. CGA includes the provision of counseling for lifestyle, screening for several cancer and noncancerous disorders, and tertiary prevention in the management of medical disorders. Providers are required at the outset to determine patient capacity and differentiate from dementia. Health-care professionals must develop an understanding of advance care planning (AACP) and steps involved in engaging patients in the process of ACP, typically earlier in life and before cognitive decline set in. One can tailor CGA and the recommendations to each individual’s health status and preferences in most settings of health care.