Comprehensive geriatric assessment: evidence

The observations of high rates of institutionalization in the frail older population and the inadequacy of provision for readily recognizable and remedial problems in this high-risk group led to the development of one of the cornerstones of modern geriatric care: the comprehensive geriatric assessment (CGA). The CGA was defined as a multidimensional, interdisciplinary diagnostic process focused on determining the medical, psychological, and functional capabilities of a frail elderly person in order to develop a coordinated and integrated plan for treatment and long-term follow-up. CGA differs from the standard medical evaluation by its concentration on frail older people with complex problems, emphasis on functional status and quality of life, use of interdisciplinary teams, and standardized and usually quantitative assessment scales. There is a range of intensity of CGA, with screening assessments designed to identify older persons’ problems performed by primary care/community health workers, and diagnostic assessment and management of these problems carried out by a multidisciplinary team with geriatric training and experience (Rubenstein et al., 1991).