Comprehensive Geriatric Assessment

The CGA is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults in order to develop a coordinated plan to maximize overall health with aging. At present, no standard criteria are available to readily identify patients who are likely to benefit from the CGA. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. Evidence coming from RCTs and large systematic reviews and meta-analyses suggests that the healthcare setting may influence the effectiveness of CGA programs. Home CGA programs as well as the CGA performed in hospital have been shown to be consistently beneficial for several health outcomes. The effectiveness of CGA programs may be modified also by particular settings or specific clinical conditions, with tailored CGA programs in older frail patients evaluated for preoperative assessment, admitted or discharged from emergency departments and orthogeriatric units or with cognitive impairment and dementia. The CGA, capable to effectively exploring multiple domains in older age, is indeed the multidimensional and multidisciplinary tool of choice to determine the clinical profile, the pathological risk and the residual skills, as well as the shortand long-term prognosis, i.e., the Multidimensional Prognostic Index (MPI), to facilitate the clinical decision making on the personalized care plan of older subjects.