Comprehensive Geriatric Assessment


Comprehensive Geriatric Assessment (CGA
) is used in geriatric medicine to capture relevant information about the health status and function of an older person. It facilitates accurate diagnosis, holistic management, and effective communication and care planning within a multi-disciplinary team. The purpose of the CGA is not so much assessment, as management. As a general rule, it's hard to make people much better than they were two weeks before they became ill. In the acute care setting, as a first approximation, a care plan is guided by that baseline level of function and health. In consequence, as a first approximation in acute care, the plan is guided by the patient's level of function and health two weeks ago.

Our team developed a standardized, single page CGA form that captures a person's current and relevant past history of function (activities of daily living) and mobility, as well as cognition, medical history (chronic and acute diseases), medication use, and social support. The standardized CGA can be used to construct a Frailty Index (FI-CGA(c)). The FI-CGA(c) appears to be a valid indicator of the health status of an older person, in that it discriminates between levels of frailty and predicts relevant outcomes such as institutionalization and death.

Download a preview of the Standardized Comprehensive Geriatric Assessment form. [PDF - 900KB]

References


Rockwood K, Stadnyk K, Carver D, MacPherson KM, Beanlands HE, Powell C, Stolee P, Thomas VS, Tonks RS. A clinimetric evaluation of specialized geriatric care for rural dwelling, frail older people. J Am Geriatr Soc. 2000 Sep;48(9):1080-5. (https://onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.2000.tb04783.x?sid=nlm%3Apubmed)

Rockwood K, Silvius JL, Fox RA. Comprehensive geriatric assessment. Helping your elderly patients maintain functional well-being. Postgrad Med. 1998 Mar;103(3):247-9, 254-8, 264. Review. (not open access - https://www.ncbi.nlm.nih.gov/pubmed/9519041)

Jones DM, Song X, Rockwood K. Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc. 2004 Nov;52(11):1929-33. (https://onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.2004.52521.x?sid=nlm%3Apubmed)