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Comprehensive Geriatric Assessment

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Advanced Age Geriatric Care

Abstract

Comprehensive geriatric assessment (CGA) forms the basis of the practice of geriatric medicine in all settings. The practice however hailed from humble beginnings and was promoted by pioneers such as Dr. Marjory Warren in the United Kingdom and Dr. Ignatz Nascher in the United States, who coined the term geriatrics, before any credible evidence as to the efficacy and cost-effectiveness of CGA. There is now considerable evidence to support the principles and practice of comprehensive geriatric assessment and geriatric evaluation and management (GEM). Whilst the application of CGA in the oldest old follows much of the same principles, its application in this population deserves special considerations, with less emphasis on prevention and more emphasis in advance care planning, end-of-life care and determination of appropriate medical intervention.

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References

  1. Barton A. History of the development of Geriatric Medicine in the UK. Postgrad Med J. 2003;79:229–34.

    Article  CAS  Google Scholar 

  2. Kong TK. Dr Marjory Warren: the mother of geriatrics. J Hong Kong Geriatric Soc. 2000;10(2):102–5.

    Google Scholar 

  3. British Geriatric Society. Marjory Warren. 2013. http://www.bgs.org.uk/geriatricmedicinearchive/bgsarchive/biographies/marjory-warren. Accessed 16 July 2017.

  4. Warren MW. The evolution of a geriatric unit from a public assistance institution. 1935-1947. Proc R Soc Medicine. 1948;41:337.

    CAS  Google Scholar 

  5. Ritch A. History of geriatric medicine: from Hippocrates to Marjory Warren. J R Coll Physicians Edinb. 2012;42(4):368–74.

    Article  CAS  Google Scholar 

  6. St John PD, Hogan DB. The relevance of Marjory Warren’s writings today. Gerontologist. 2014;54(1):21–9.

    Article  Google Scholar 

  7. Mathews DA. Dr Marjory Warren and the origins of British geriatrics. J Am Geriatric Soc. 1984;32(4):253–8.

    Article  Google Scholar 

  8. Stuck AE, et al. Comprehensive Geriatric Assessment: a meta-analysis of controlled trials. Lancet. 1993;342:1032–6.

    Article  CAS  Google Scholar 

  9. Ekerstad N, Karusin BW, Ivanoff SD, Landahl S, Anderson D, Heintz E, et al. Is acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care? Clin Intern Aging. 2017;12:1–9.

    Google Scholar 

  10. Ellis G, Whitehead M, O’Neill D, Langhorne P, Robinson D. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2014; https://doi.org/10.1002/14651858.CD006211.pub2. Accessed 17 July 2017.

  11. Caillet P, Laurent M, Bastuji-Garin S, Liuu E, Culne S, Lagrange J-L, et al. Optimal management of elderly cancer patients: usefulness of the comprehensive geriatric assessment. Clin interv Aging. 2014;9:1645–60.

    PubMed  PubMed Central  Google Scholar 

  12. Ungar A, Mannarin G, van der Valde N, Baan J, Thibodeau MP, Masson J-B, et al. Comprehensive Geriatric Assessment in patients undergoing transcatheter aortic valve implantation-result from the CGA-TAVI multi-centre registry. BMC Cardiovasc Disord. 2018;18(1):1.

    Article  Google Scholar 

  13. Mahoney FI, Barthel DW. Functional evaluation-barthel index. Md State Med J. 1965;14:61–5.

    CAS  Google Scholar 

  14. Lawton MR, Brody EM. Assessment of older people: self -maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.

    Article  CAS  Google Scholar 

  15. Lubben JE. Assessing social network among elderly population. Fam Community Health. 1988;11(3):842–52.

    Google Scholar 

  16. Folstein MF, Folstein SE, PL MH. “Mini-mental status”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.

    Article  CAS  Google Scholar 

  17. Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, Hodges JR. A brief cognitive test battery to differentiate Alzheimer’s and fronto-temporal dementia. Neurology. 2000;55(11):1613–20.

    Article  CAS  Google Scholar 

  18. Hodge JR, Larner JH. Addenbrooke’s cognitive examination: ACE, ACER, ACE III, ACE app and M ACE. In: Cognitive screening instruments. A practical approach. Cham: Springer; 2017. p. 109–37.

    Chapter  Google Scholar 

  19. Storey J, Rowland JT, Basic D, Conforti DA, Dickson HG. The Rowland Universal Dementia Assessment Scale: a multicultural cognitive assessment scale. Int Psychgeriatr. 2004;16(1):13–31.

    Article  Google Scholar 

  20. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a Geriatric Depression Screening Scale. A preliminary report. J Psch Res. 1983;17(1):37–49.

    Article  CAS  Google Scholar 

  21. O’Keefe S. Deconditioning in old age. https://doi.org/10.13140/2.1.3889.1846 or Deconditioning in old age. In: Ekerdt DK, editors. Book: Encyclopaedia of aging, Macmillan: Reference USA. p. 2005–9.

  22. Mathias S, Nayak USL, Issacs R. Balance in elderly patients, the “get up and go” test. Arch Phys Med Rehabil. 1986;14(6):387–9.

    Google Scholar 

  23. Rubenstein LZ, Harker JO. Screening for under-nutrition in geriatric practice: developing the short form mini-nutritional assessment (MNA-SF). J Gerontol. 2001;56A:M366–72.

    Article  Google Scholar 

  24. World Health Organiszation. 1974. http://apps.who.ont/iris/bitstream/handle/10665/43030/9241592184.pdf?sequence=1.

  25. Nicholas JA, Hall WA. Screening and preventive services for older adults. Mt Sinai J Med. 2011;78(4):498–509.

    Article  Google Scholar 

  26. ABS 2009. http://www.abs.gov.au/ausstats/abs@.nsf/Previousproducts/4430.0Main%20Features22009.

  27. Fried L, Ferrucci L, Durer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty and co-morbidity: implications for improved targeting and care. Journal of Gerontology: Medical Science. 2004;59(3):255–63.

    Google Scholar 

  28. Almy TP, et al. Subcommittee. American College of Physicians, Health and Public Policy Committee. Position Paper 1. Comprehensive functional assessment for elderly patients. Ann Intern Med. 1988;70–2.

    Google Scholar 

  29. Medicare benefit schedule book. November 2000 ed. Canberra: Department of Health and Aged Care; 2000.

    Google Scholar 

  30. www.who.int/ageing/publications/AF_PHC_Centretoolkit.pdf.

  31. Ward KT. Comprehensive geriatric assessment. Uptodate. http://www.uptodate.com/content/comprehensive-geriatric-assessment. Accessed 16 July 2017.

  32. Dupee R. Geriatric assessment. 2. Aging.ocw.tufts.edu/data/42/490303.pdf. Assessed 24 Apr 2018.

  33. Mohd-sidik S, Aroll B, Goodyear-Smith F, Zain AM. Screening for depression with a brief questionnaire in a primary care setting: validation of two questions with help question (Malay version). Int J Psychiatry Med. 2011;41(2):143–54.

    Article  Google Scholar 

  34. British Geriatric Society. Comprehensive assessment of the frail older patient. http://www.bgs.org.uk/good-practice-guides/resources/goodpractice/gpgassessment. Accessed 6 Jan 2017.

  35. Walston JD, Fried LP. Frailty and its implications for care. In: Morrison RS, Meir DE, editors. Geriatric palliative care. New York: Oxford University Press; 2003.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Geriatric Medicine, Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Authors
  1. Gary Cheuk
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Corresponding author

Correspondence to Gary Cheuk .

Editor information

Editors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

  2. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Kujan Nagaratnam

  3. Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Multiple Choice Questions (MCQs)

Multiple Choice Questions (MCQs)

  1. 1.

    The following in relation to comprehensive geriatric assessment are true, EXCEPT:

    1. A.

      Comprehensive geriatric assessment is carried out most successfully by a multidisciplinary team.

    2. B.

      Medicare Benefits Schedule does not have set requirements for payments to primary care physicians for assessments.

    3. C.

      The outcome of the comprehensive assessment is the development of the care plan.

    4. D.

      A comprehensive screen consisting of a group of targeted instruments would be useful to assess functional deficits methodically.

Answers to MCQs

  1. 1.

    B

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Cheuk, G. (2019). Comprehensive Geriatric Assessment. In: Nagaratnam, N., Nagaratnam, K., Cheuk, G. (eds) Advanced Age Geriatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-96998-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-96998-5_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96997-8

  • Online ISBN: 978-3-319-96998-5

  • eBook Packages: MedicineMedicine (R0)

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