Comprehensive geriatric assessment – a guide for the non‐specialist

Abstract

Comprehensive geriatric assessmenta guide for the non-specialist Comprehensive geriatric assessment (CGA) is the most comprehensively researched model for healthcare delivery to frail older patients.It has been shown, through a series of high-quality research studies and subsequent meta-analyses, to deliver measurable health improvements for frail older people.Although it is well understood by specialists in care of older people, it remains unrecognised by many non-specialists.Because it is a multifaceted complex intervention, whose title and acronym do not convey its full meaning, it may be misunderstood by those unfamiliar with it.Given the demonstrated benefits from CGA for frail older patientswho now increasingly represent 'core business' to healthcare professionals of all types, across all developed healthcare economiesit is important that this model of healthcare delivery is more widely understood.The purpose of this article is to explain, for a non-specialist clinical readership, what CGA is and how it works. What is comprehensive geriatric assessment?Comprehensive geriatric assessment is not a term which is widely used outside of specialist circles despite being in existence for over 20 years.It is often taken to be synonymous with 'geriatric medicine'.This is not the case.CGA is a process which is used to manage frail or vulnerable older people.It is interdisciplinarymeaning that it takes account of inputs not only from doctors but also nurses and allied health professionals.It is multidimensionalmeaning that it takes account not just of medical diagnoses but also functional impairments and the environmental and social issues which affect patient wellbeing.It produces problem lists and develops goal-driven interventions to tackle these.Ultimately, it provides and coordinates an integrated plan for treatment, rehabilitation, support and long-term care.Recognising that CGA is more than an assessment process, some people prefer the term geriatric evaluation and management (GEM).In this article, we use the term CGA simply because this is most commonly used in the evidence base.