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Chapter 3 - Comprehensive Geriatric Assessment

from Section I - General Approach to the Care of the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Serena P. Wong ,
Kristin Hlebowitsh  and
Mitchell T. Heflin
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

Comprehensive geriatric assessment is a holistic approach to care involving multifaceted patient-centered evaluation and management. Often involving interprofessional teams, it can be adapted to different care settings according to available resources and prioritized goals.

Keywords

comprehensive geriatric assessmentperson-centered careinterprofessional assessment
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 21 - 32
Publisher: Cambridge University Press
Print publication year: 2022

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References

Pilotto, A, Cella, A, Pilotto, A, Daragjati, J, Veronese, N, Musacchio, C, Mello, AM, Logroscino, G, Padovani, A, Prete, C, Panza, F. Three decades of Comprehensive Geriatric Assessment: Evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc. 2017 (Feb. 1); 18(2):192.e1–192.e11. PMID: 28049616.Google Scholar
Ivanoff, SD, Duner, A, Eklund, K, Wilhelmson, K, Lidén, E, Holmgren, E. Comprehensive Geriatric Assessment of frail older people: Ideals and reality. J Interprof Care. 2018 (Nov.); 32(6):728–734. PMID: 30156945.CrossRefGoogle Scholar
Bachmann, S, Finger, C, Huss, A, Egger, M, Stuck, AE, Clough-Gorr, KM. Inpatient rehabilitation specifically designed for geriatric patients: Systematic review and meta-analysis of randomised controlled trials. BMJ. 2010 (Apr. 20); 340:c1718. PMCID: PMC2857746.CrossRefGoogle ScholarPubMed
Briggs, R, McDonough, A, Ellis, G, Bennett, K, O’Neill, D, Robinson, D. Comprehensive Geriatric Assessment for community‐dwelling, high‐risk, frail, older people. Cochrane Database Syst Rev. 2017 (Jun. 28) [cited 2020 Jun. 22]; (6). www.ncbi.nlm.nih.gov/pmc/articles/PMC6481754. PMCID: PMC6481754.Google Scholar
Deschodt, M, Flamaing, J, Haentjens, P, Boonen, S, Milisen, K. Impact of geriatric consultation teams on clinical outcome in acute hospitals: A systematic review and meta-analysis. BMC Med. 2013 (Feb. 22); 11:48. PMCID: PMC3626668.CrossRefGoogle ScholarPubMed
Booth, KA, Simmons, EE, Viles, AF, Gray, WA, Kennedy, KR, Biswal, SH, Lowe, JA, Xhaja, A, Kennedy, RE, Brown, CJ, Flood, KL. Improving geriatric care processes on two medical-surgical acute care units: A pilot study. J Healthc Qual Off Publ Natl Assoc Healthc Qual. 2019 (Feb.); 41(1):23–31. PMID: 29794813.Google Scholar
Buurman, BM, Parlevliet, JL, van Deelen, BAJ, de Haan, RJ, de Rooij, SE. A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: The Transitional Care Bridge. BMC Health Serv Res. 2010 (Oct. 29); 10:296. PMCID: PMC2984496.CrossRefGoogle ScholarPubMed
Reuben, DB, Frank, JC, Hirsch, SH, McGuigan, KA, Maly, RC. A randomized clinical trial of outpatient comprehensive geriatric assessment coupled with an intervention to increase adherence to recommendations. J Am Geriatr Soc. 1999 (Mar.); 47(3):269–276. PMID: 10078887.Google Scholar
Boult, C, Boult, LB, Morishita, L, Dowd, B, Kane, RL, Urdangarin, CF. A randomized clinical trial of outpatient geriatric evaluation and management. J Am Geriatr Soc. 2001 (Apr.); 49(4):351–359. PMID: 11347776.CrossRefGoogle ScholarPubMed
Hernandez Torres, C, Hsu, T. Comprehensive Geriatric Assessment in the older adult with cancer: A review. Eur Urol Focus. 2017 (Oct.); 3(4–5):330–339. PMID: 29331624.CrossRefGoogle ScholarPubMed
Partridge, JSL, Collingridge, G, Gordon, AL, Martin, FC, Harari, D, Dhesi, JK. Where are we in perioperative medicine for older surgical patients? A UK survey of geriatric medicine delivered services in surgery. Age Ageing. 2014 (Sep.); 43(5):721–724. PMID: 25092720.CrossRefGoogle ScholarPubMed
Eamer, G, Taheri, A, Chen, SS, Daviduck, Q, Chambers, T, Shi, X, Khadaroo, RG. Comprehensive Geriatric Assessment for older people admitted to a surgical service. Cochrane Database Syst Rev. 2018 (Jan. 31); 1:CD012485. PMCID: PMC6491328.CrossRefGoogle Scholar
National Center for Health Statistics. National Health Interview Survey, 2018. 2019. www.cdc.gov/nchs/nhis/data-questionnaires-documentation.htm.Google Scholar
Fillenbaum, GG. Screening the elderly: A brief instrumental activities of daily living measure. J Am Geriatr Soc. 1985 (Oct.); 33(10):698–706. PMID: 4045087.Google Scholar
Liebzeit, D, King, B, Bratzke, L. Measurement of function in older adults transitioning from hospital to home: An integrative review. Geriatr Nurs N Y N. 2018 (Jun.); 39(3):336–343. PMCID: PMC6473790.CrossRefGoogle ScholarPubMed
Rosen, SL, Reuben, DB. Geriatric assessment tools. Mt Sinai J Med. 2011; 78:489–497.Google Scholar
Faber, MJ, Bosscher, RJ, van Wieringen, PC. Clinimetric properties of the performance-oriented mobility assessment. Phys Ther. Oxford Academic; 2006 (Jul. 1); 86(7):944–954.Google Scholar
Tinetti, ME, Speechley, M, Ginter, SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. Massachusetts Medical Society; 1988 (Dec.); 319(26):1701–1707.CrossRefGoogle ScholarPubMed
US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. STEADI toolkit. www.cdc.gov/steadi.Google Scholar
Stevens, JA, Phelan, EA. Development of STEADI: A fall prevention resource for health care providers. Health Promot Pract. NIH Public Access; 2013 (Sep.); 14(5):706–714.Google Scholar
Kinnucan, E, Molcjan, MT, Wright, DM, Switzer, JA. A prospective look at the link between frailty and shoulder function in asymptomatic elderly individuals. Geriatr Orthop Surg Rehabil. SAGE Publications; 2018 (Jan.); 9.CrossRefGoogle Scholar
Siu, AL, Bibbins-Domingo, K, Grossman, DC, Baumann, LC, Davidson, KW, Ebell, M, García, FAR, Gillman, M, Herzstein, J, Kemper, AR, Krist, AH, Kurth, AE, Owens, DK, Phillips, WR, Phipps, MG, Pignone, MP. Screening for impaired visual acuity in older adults: US preventive services task force recommendation statement. JAMA. 2016 (Mar.); 315(9):908–914. PMID: 26934260.Google ScholarPubMed
American Academy of Ophthalmology. Frequency of Ocular Examinations. 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations.Google Scholar
Chou, R, Dana, T, Bougatsos, C, Grusing, S, Blazina, I. Screening for impaired visual acuity in older adults: Updated evidence report and systematic review for the US preventive services task force. JAMA. 2016 (Mar.); 315(9):915–933.CrossRefGoogle ScholarPubMed
Loughrey, DG, Kelly, ME, Kelley, GA, Brennan, S, Lawlor, BA. Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: A systematic review and meta-analysis. JAMA Otolaryngol – Head Neck Surg. 2018 (Feb.); 144(2):115–126. PMID: 29222544.Google Scholar
Sindhusake, D, Mitchell, P, Smith, W, Golding, M, Newall, P, Hartley, D, Rubin, G, Mitchell, AP. Validation of self-reported hearing loss: The Blue Mountains Hearing Study. Int J Epidemiol. 2001; 30(6):1371–1378.CrossRefGoogle ScholarPubMed
Raphael, C. Oral health and aging. Am J Public Health. 2017 (Jun.); 107(S1):S44–S45.Google Scholar
Okamoto, N, Amano, N, Nakamura, T, Yanagi, M. Relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly: A cross-sectional study. BMC Oral Health. BioMed Central Ltd.; 2019 (Jun.); 19(1).Google Scholar
O’Reilly, N, Nelson, HD, Conry, JM, Frost, J, Gregory, KD, Kendig, SM, Phipps, M, Salganicoff, A, Ramos, D, Zahn, C, Qaseem, A. Women’s Preventive Services Initiative: Screening for urinary incontinence in women – A recommendation from the Women’s Preventive Services Initiative. Ann Intern Med. 2018 (Sep. 4); 169(5):320–328. PMID: 30105360.CrossRefGoogle ScholarPubMed
Rubenstein, LZ, Harker, JO, Salvà, A, Guigoz, Y, Vellas, B. Screening for undernutrition in geriatric practice: Developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001 (Jun.); 56(6):M366–372. PMID: 11382797.Google Scholar
Wilson, M-MG, Thomas, DR, Rubenstein, LZ, Chibnall, JT, Anderson, S, Baxi, A, Diebold, MR, Morley, JE. Appetite assessment: Simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005 (Nov.); 82(5):1074–1081. PMID: 16280441.Google Scholar
Kritchevsky, SB, Beavers, KM, Miller, ME, Shea, MK, Houston, DK, Kitzman, DW, Nicklas, BJ. Intentional weight loss and all-cause mortality: A meta-analysis of randomized clinical trials. PLoS ONE. 2015 (Mar.); 10(3).CrossRefGoogle ScholarPubMed
Batsis, JA, Villareal, DT. Sarcopenic obesity in older adults: Aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018 (Sep.); 14:513–537.Google Scholar
Villareal, DT, Aguirre, L, Gurney, AB, Waters, DL, Sinacore, DR, Colombo, E, Armamento-Villareal, R, Qualls, C. Aerobic or resistance exercise, or both, in dieting obese older adults. N Engl J Med. 2017 (May); 376(20):1943–1955. PMID: 28514618.Google Scholar
Soenen, S, Chapman, IM. Body weight, anorexia, and undernutrition in older people. J Am Med Dir Assoc. Elsevier Ltd; 2013; 14(9):642–648.CrossRefGoogle ScholarPubMed
Steiner, JF, Stenmark, SH, Sterrett, AT, Paolino, AR, Stiefel, M, Gozansky, WS, Zeng, C. Food insecurity in older adults in an integrated health care system. J Am Geriatr Soc. 2018; 66(5):1017–1024.Google Scholar
Holsinger, T, Deveau, J, Boustani, M, Williams, JW. Does this patient have dementia? J Am Med Assoc. 2007 (Jun.); 297(21):2391–2404.Google Scholar
Matiás-Guiu, JA, Valles-Salgado, M, Rognoni, T, Hamre-Gil, F, Moreno-Ramos, T, Matiás-Guiu, J. Comparative diagnostic accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for screening of Alzheimer disease. Dement Geriatr Cogn Disord. 2017 (Jun.); 43(5–6):237–246.CrossRefGoogle ScholarPubMed
Casey, DA. Depression in older adults: A treatable medical condition. Prim Care. 2017 (Sep.); 44(3):499–510. PMID: 28797375.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001 (Sep.); 16(9):606–613. PMCID: PMC1495268.Google Scholar
Li, C, Friedman, B, Conwell, Y, Fiscella, K. Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people. J Am Geriatr Soc. 2007 (Apr.); 55(4):596–602. PMID: 17397440.Google Scholar
Yesavage, JA, Sheikh, JI. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin Gerontol. 1986 (Nov. 18); 5(1–2):165–173.CrossRefGoogle Scholar
Fried, TR, O’Leary, J, Towle, V, Goldstein, MK, Trentalange, M, Martin, DK. Health outcomes associated with polypharmacy in community-dwelling older adults: A systematic review. J Am Geriatr Soc. 2014 (Dec.); 62(12):2261–2272. PMCID: PMC4270076.Google Scholar
Scott, IA, Hilmer, SN, Reeve, E, Potter, K, Le Couteur, D, Rigby, D, Gnjidic, D, Del Mar, CB, Roughead, EE, Page, A, Jansen, J, Martin, JH. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Intern Med. 2015 (May); 175(5):827–834. PMID: 25798731.Google Scholar
American Geriatrics Society Beers Criteria® Update Expert Panel. Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019; 67(4):674–694. PMID: 30693946.Google Scholar
Rhee, TG, Marottoli, RA, Cooney, LM, Fortinsky, RH. Associations of social and behavioral determinants of health index with self-rated health, functional limitations, and health services use in older adults. J Am Geriatr Soc. 2020 (Mar.) 30. PMID: 32227645.Google Scholar
Steptoe, A, Shankar, A, Demakakos, P, Wardle, J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci USA. 2013 (Apr.); 110(15):5797–5801. PMID: 23530191.CrossRefGoogle ScholarPubMed
Hanratty, B, Stow, D, Collingridge Moore, D, Valtorta, NK, Matthews, F. Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing. Age Ageing. 2018; 47:896–900.Google Scholar
Mosqueda, L, Widera, E, Smith, A. Elder mistreatment: Podcast with Laura Mosqueda [cited 2020 Jun. 25]. www.geripal.org/2020/06/elder-mistreatment-podcast-with-laura.html.Google Scholar
Yee Wong, W, Bunn, A, Ramprasad, S. Spirituality and aging support groups: A psycho-spiritual intervention to address the mental health needs of older adults. Ann Long Term Care. 2019; 27(6):e13–e18.Google Scholar
Borneman, T, Ferrell, B, Puchalski, CM. Evaluation of the FICA tool for spiritual assessment. J Pain Symptom Manage. 2010 (Aug.); 40(2):163–173.Google Scholar
World Health Organization. World Conference on Social Determinants of Health [cited 2020 Jun. 25]. www.who.int/social_determinants/sdhconference/case_studies/en.Google Scholar
Health Leads. The Health Leads Screening Toolkit [cited 2020 Jun. 25]. https://healthleadsusa.org/resources/the-health-leads-screening-toolkit.Google Scholar
Golden, RL, Emery-Tiburcio, EE, Post, S, Ewald, B, Newman, M. Connecting social, clinical, and home care services for persons with serious illness in the community. J Am Geriatr Soc. 2019 (May); 67(S2):S412–S418. PMID: 31074858.CrossRefGoogle ScholarPubMed
Reuben, DB. Medical care for the final years of life: “When you’re 83, it’s not going to be 20 years.” J Am Med Assoc. 2009 (Dec. 23); 302(24):2686–2694. PMCID: PMC2822435.CrossRefGoogle ScholarPubMed
Yourman, LC, Lee, SJ, Schonberg, MA, Widera, EW, Smith, AK. Prognostic indices for older adults: A systematic review. J Am Med Assoc. 2012 (Jan. 11); 307(2):182–192. PMCID: PMC3792853.Google Scholar
Stoop, A, Lette, M, van Gils, PF, Nijpels, G, Baan, CA, de Bruin, SR. Comprehensive geriatric assessments in integrated care programs for older people living at home: A scoping review. Health Soc Care Community. 2019 (Sep.); 27(5):e549–e566. PMCID: PMC6852049.Google Scholar
Counsell, SR, Callahan, CM, Clark, DO, Tu, W, Buttar, AB, Stump, TE, Ricketts, GD. Geriatric care management for low-income seniors: A randomized controlled trial. J Am Med Assoc. 2007 (Dec. 12); 298(22):2623–2633. PMID: 18073358.Google Scholar
Hermush, V, Daliot, D, Weiss, A, Brill, S, Beloosesky, Y. The impact of geriatric consultation on the care of the elders in community clinics. Arch Gerontol Geriatr. 2009 (Oct.); 49(2):260–262. PMID: 18996605.Google Scholar
Reuben, DB, Roth, C, Kamberg, C, Wenger, NS. Restructuring primary care practices to manage geriatric syndromes: The ACOVE-2 intervention. J Am Geriatr Soc. 2003 (Dec.); 51(12):1787–1793. PMID: 14687359.Google Scholar
Theou, O, Park, GH, Garm, A, Song, X, Clarke, B, Rockwood, K. Reversing frailty levels in primary care using the CARES model. Can Geriatr J. 2017 (Sep.); 20(3):105–111. PMCID: PMC5624254.Google Scholar
Boyd, CM, Boult, C, Shadmi, E, Leff, B, Brager, R, Dunbar, L, Wolff, JL, Wegener, S. Guided care for multimorbid older adults. The Gerontologist. 2007 (Oct.); 47(5):697–704. PMID: 17989412.Google Scholar
Boult, C, Leff, B, Boyd, CM, Wolff, JL, Marsteller, JA, Frick, KD, Wegener, S, Reider, L, Frey, K, Mroz, TM, Karm, L, Scharfstein, DO. A matched-pair cluster-randomized trial of guided care for high-risk older patients. J Gen Intern Med. 2013 (May); 28(5):612–621. PMCID: PMC3631081.Google Scholar
Nord, M, Östgren, CJ, Marcusson, J, Johansson, M. Staff experiences of a new tool for comprehensive geriatric assessment in primary care (PASTEL): A focus group study. Scand J Prim Health Care. 2020 (Apr. 29); 1–14. PMID: 32349567.Google Scholar
Saraiva, MD, Venys, AL, Abdalla, FLP, Fernandes, MS, Pisoli, PH, Sousa, DM da, RV, Bianconi, BL, Henrique, EÂ, Garcia, VSS, Maia, LH de M, Suzuki, GS, Serrano, PG, Hiratsuka, M, Szlejf, C, Jacob-Filho, W, Paschoal, SMP. AMPI-AB validity and reliability: A multidimensional tool in resource-limited primary care settings. BMC Geriatr. 2020 (Mar. 30); 20(1):124. PMCID: PMC7106646.Google Scholar
Morley, JE, Little, MO, Berg-Weger, M. Rapid Geriatric Assessment: A tool for primary care physicians. J Am Med Dir Assoc. 2017; 18(3):195–199. PMID: 28108203.Google Scholar
Morley, JE, Adams, EV. Rapid Geriatric Assessment. J Am Med Dir Assoc. 2015 (Oct. 1); 16(10):808–812. PMID: 26433860.Google Scholar
Harris, SS, Link, CL, Tennstedt, SL, Kusek, JW, McKinlay, JB. Care seeking and treatment for urinary incontinence in a diverse population. J Urol. 2007 (Feb.); 177(2):680–684. PMID: 17222656.CrossRefGoogle Scholar
Valcour, VG, Masaki, KH, Curb, JD, Blanchette, PL. The detection of dementia in the primary care setting. Arch Intern Med. 2000 (Oct. 23); 160(19):2964–2968. PMID: 11041904.Google Scholar
Tkatch, R, Musich, S, MacLeod, S, Alsgaard, K, Hawkins, K, Yeh, CS. Population health management for older adults: Review of interventions for promoting successful aging across the health continuum. Gerontol Geriatr Med. 2016 (Dec.); 2:2333721416667877. PMCID: PMC5486489.Google Scholar

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