Comprehensive Geriatric Assessment
Older adults are prone to declines in physical function and cognition that can threaten their independence and quality of life. Traditional biomedical assessment focused on diagnosing and treating individual diseases can miss early manifestations of declines in health and ability that, when recognized and treated, can prevent adverse outcomes and improve quality of life.[1] Detecting and intervening upon these “geriatric syndromes” requires a multidimensional assessment including measures of physical, cognitive, affective, social, financial, and environmental domains. Comprehensive geriatric assessment (CGA) offers a holistic approach to care that accounts for these domains by developing care plans that aim to improve health outcomes, including function, safety, and quality of life. Traditionally, CGA is performed by a multidisciplinary, interprofessional team working collaboratively to collect data and develop care plans. The approach and outcomes, however, are highly dependent on the care setting and available resources and professions. Models include those focused on care of older adults in hospitals, long-term care, ambulatory practice, and home care. Alternatively, condition-focused versions provide CGA for patients with cancer or dementia, or for those having surgery. While CGA has proliferated in many forms with the growth of the older adult population, it also suffers from a number of practical challenges when implemented in a busy clinical practice.[2] In this chapter, we provide an overview of the evidence for CGA, a guide to its key components, and a practical vision for its implementation in primary care practice.
