π§ Comprehensive Geriatric Assessment (CGA)
A Comprehensive Geriatric Assessment (CGA) is a structured, multidisciplinary process that evaluates an older personβs medical, psychological, functional, and social well-being.
β¨ The goal is to design an integrated, personalised care plan that promotes independence, dignity, and quality of life.
ποΈ Key Components of CGA
- π©Ί Medical Assessment
- π Full review of acute & chronic illnesses (diabetes, hypertension, arthritis).
- π Medication review β polypharmacy, drug interactions, adherence issues.
- π₯ Nutrition & hydration β malnutrition, sarcopenia, vitamin deficiencies.
- β οΈ Screen for frailty syndromes β delirium, falls, incontinence, sensory loss.
- π Functional Assessment
- π§Ό ADLs (Activities of Daily Living): bathing, dressing, eating, toileting.
- π IADLs (Instrumental ADLs): shopping, finances, medication management.
- πΆ Mobility & gait β fall risk assessment, walking aids, balance tests (e.g. Timed Up & Go).
- π§ Cognitive & Psychological Assessment
- π§© Cognitive screening: AMTS, MoCA, MMSE.
- π Mood assessment: depression/anxiety screening (e.g. Geriatric Depression Scale).
- π Behavioural symptoms in dementia β agitation, hallucinations.
- πͺ Social Assessment
- π€ Support networks: family, carers, community resources.
- π Living arrangements: safety, accessibility, isolation risk.
- π· Financial challenges β medication costs, benefits, safeguarding.
- π‘ Environmental Assessment
- π‘ Home safety: lighting, stairs, trip hazards, bathroom access.
- π Transport & access to healthcare, social clubs, day centres.
- π Advance Care Planning
- π― Define goals of care, patient values & preferences.
- β€οΈ Discuss resuscitation status, advance directives, and ReSPECT forms.
π Benefits of CGA
- π Improved diagnosis: identifies hidden conditions (memory loss, anaemia, malnutrition).
- π§ββοΈ Individualised care: treatment tailored to frailty and functional reserve.
- π‘οΈ Prevents deterioration: reduces falls, delirium, deconditioning, and readmissions.
- π₯ Fewer hospitalisations: CGA shortens length of stay and improves discharge planning.
- πͺ Better frailty outcomes: enhances mobility, function, and survival.
- π Quality of life: holistic care β dignity, comfort, and independence.
π₯ Who Benefits Most?
- β‘ Frail or pre-frail older adults.
- π Patients with multiple chronic diseases and polypharmacy.
- π§ People with dementia, delirium, or cognitive impairment.
- π¨ Those with recent decline (falls, weight loss, hospital admission).
π€ The Multidisciplinary Team (MDT)
- π¨ββοΈ Geriatrician: leads assessment, manages complex comorbidities.
- π©ββοΈ Nurses: daily care, wound management, medication education.
- π Physiotherapists: mobility, balance, fall prevention, rehab.
- ποΈ Occupational Therapists (OT): ADL training, home adaptations, equipment.
- π§Ύ Social Workers: benefits, care packages, safeguarding concerns.
- π§ Psychologist / Psychiatrist: cognitive testing, mood disorders, behavioural support.
- π₯ Dietitians: malnutrition, diabetes, supplements, feeding support.
- π£οΈ Speech & Language Therapists (SALT): swallowing, communication aids.
π Take-home message: CGA is not a one-off test but a dynamic, collaborative process.
It transforms complex problems into a clear, shared care plan that empowers patients, supports families, and reduces system strain.