Comprehensive Geriatric Assessment (CGA)
🧓 Comprehensive Geriatric Assessment (CGA)
A Comprehensive Geriatric Assessment (CGA) is a structured, multidisciplinary process that evaluates an older person’s medical, psychological, functional, and social well-being.
✨ The goal is to design an integrated, personalised care plan that promotes independence, dignity, and quality of life.
🗝️ Key Components of CGA
- 🩺 Medical Assessment
- 📖 Full review of acute & chronic illnesses (diabetes, hypertension, arthritis).
- 💊 Medication review → polypharmacy, drug interactions, adherence issues.
- 🥗 Nutrition & hydration → malnutrition, sarcopenia, vitamin deficiencies.
- ⚠️ Screen for frailty syndromes → delirium, falls, incontinence, sensory loss.
- 🏃 Functional Assessment
- 🧼 ADLs (Activities of Daily Living): bathing, dressing, eating, toileting.
- 🛒 IADLs (Instrumental ADLs): shopping, finances, medication management.
- 🚶 Mobility & gait → fall risk assessment, walking aids, balance tests (e.g. Timed Up & Go).
- 🧠 Cognitive & Psychological Assessment
- 🧩 Cognitive screening: AMTS, MoCA, MMSE.
- 🙂 Mood assessment: depression/anxiety screening (e.g. Geriatric Depression Scale).
- 🔔 Behavioural symptoms in dementia → agitation, hallucinations.
- 👪 Social Assessment
- 🤝 Support networks: family, carers, community resources.
- 🏠 Living arrangements: safety, accessibility, isolation risk.
- 💷 Financial challenges → medication costs, benefits, safeguarding.
- 🏡 Environmental Assessment
- 💡 Home safety: lighting, stairs, trip hazards, bathroom access.
- 🚌 Transport & access to healthcare, social clubs, day centres.
- 📜 Advance Care Planning
- 🎯 Define goals of care, patient values & preferences.
- ❤️ Discuss resuscitation status, advance directives, and ReSPECT forms.
🌟 Benefits of CGA
- 🔎 Improved diagnosis: identifies hidden conditions (memory loss, anaemia, malnutrition).
- 🧑⚕️ Individualised care: treatment tailored to frailty and functional reserve.
- 🛡️ Prevents deterioration: reduces falls, delirium, deconditioning, and readmissions.
- 🏥 Fewer hospitalisations: CGA shortens length of stay and improves discharge planning.
- 💪 Better frailty outcomes: enhances mobility, function, and survival.
- 😊 Quality of life: holistic care → dignity, comfort, and independence.
👥 Who Benefits Most?
- ⚡ Frail or pre-frail older adults.
- 💊 Patients with multiple chronic diseases and polypharmacy.
- 🧠 People with dementia, delirium, or cognitive impairment.
- 🚨 Those with recent decline (falls, weight loss, hospital admission).
🤝 The Multidisciplinary Team (MDT)
- 👨⚕️ Geriatrician: leads assessment, manages complex comorbidities.
- 👩⚕️ Nurses: daily care, wound management, medication education.
- 🏃 Physiotherapists: mobility, balance, fall prevention, rehab.
- 🛋️ Occupational Therapists (OT): ADL training, home adaptations, equipment.
- 🧾 Social Workers: benefits, care packages, safeguarding concerns.
- 🧠 Psychologist / Psychiatrist: cognitive testing, mood disorders, behavioural support.
- 🥗 Dietitians: malnutrition, diabetes, supplements, feeding support.
- 🗣️ Speech & Language Therapists (SALT): swallowing, communication aids.
🌍 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.
