Comprehensive Geriatric Analysis
Comprehensive Geriatric Assessment (CGA)
CGA defined as: “ a multidisciplinary approach for diagnosis and treatment as well as identification of medical , psychosocial , and functional limitations of a frail older person . The aim is to develop a coordinated plan to improve overall health with aging” (168).
The gold standard program for the evaluation and management of geriatric people is the (CGA). It provides a holistic, multidisciplinary assessment by number of specialist from different fields of medicine. It is well demonstrated that this program can improve outcome in a variety of situations (169).
CGA is the most effective and powerful tool to provide suitable care and management for geriatric population through
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2- Hospital barriers such as absence of training staff, insufficient time, resources and communications. Therefore it is essential to increase the level of education and change the direction of the resources toward the growing segment of population (older people) with their complex illnesses (173).
CGA is an integrated approach for assessment of elderly individuals based on certain principles includes 1- multidimensional. 2-interdisciplanary. 3- Older individual is the center of the process. 4-assessment methods should be standardized (174).
Goals of geriatric assessment
In order to achieve its purposes, CGA involve a systematic approach to assess the main component of the process. The main goals of CGA are to improve quality of life and to maintain function (175).
1-center upon preventive medicine more than acute medicine.
2-center upon maintaining and improvement of functional ability rather than cure.
3-diagnosis of health related
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4- Nutritional evaluation: another part in medical assessment of geriatric people is the .Type of food, frequency and quality of food, chewing ability and swallowing should be carefully evaluated. The simple tool (appendix 5) used for screening nutrition in older people is the “nutritional health checklist (177).
3-Psychological assessment
Two important conditions that may lead to considerable impact on patient and their families are the cognitive impairment and the most important is the depression. Screening for both conditions is of valuable impact with significant outcome on geriatric patients (175).
1-cognetive assessment (178). Which can be best performed by (MMSE) mini-mental state examination (appendix 6).
2- Depression is the most common, reversible problem in geriatrics which can lead increase risk of death (179) .Depression can be easily screened by the short modified version of the most widely used (GDS ) geriatric depression scale which consist of 30 items (appendix
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