Comprehensive Geriatric Assessment

Question 1

What is Frailty?

Answer 1

‘Frailty is a clinically recognised state of
increased vulnerability.
It results from ageing associated with a decline
in the body’s physical and psychological
reserves’
Fit for Frailty - consensus best practice guidance for the care of older people living in community and outpatient

Question 2

What is a comprehensive geriatric assessement (CGA)?

Answer 2

Gold standard for
management of frailty

• Multidimensional,
interdisciplinary
diagnostic process

• It works:
• ↓mortality
• ↓functional decline
• ↓institutionalisation
• ↓cognitive decline

Question 3

Explain taking a falls history

Answer 3

Pre-fall
• What were you doing at the time?
• Dizzy? Lightheaded?
• Unwell at all recently?
• Mobility?
 During the collapse
• Recall events?
• witnessed?
• Injuries give clues?
Post-fall
• Jerking? Incontinence?
• Recovery time?
• Confusion?
• Mobility?
Past Medical Hx and Drug Hx
• Diabetes?
• High BP?
• Epilepsy?
• Previous falls?
• Cardiac history?
• Neurological problems?
• Vision?
• Cognition?
• Bone health?
• Alcohol?
• Medications?

Examination
• Head to toe examination
• Neurological exam
• CVS exam
• Respiratory exam
BP
• Lying/Standing BP
Gait assessment
• Compare to previous
Discharge ? Safe

Question 4

Explain delirium and cognitive impairment

Answer 4

<2mins
Easy and simple

• Alertness (4)
• AMT4 (Age, DOB, Place, Year) (2)
• Attention (2)
• Acute change or fluctuating course (2)

Score (12)
0= unlikely
1-3 = possible cognitive impairment
>4 = possible delirium +/- cog impairment

Question 5

Explain the difference between dementia and delirium

Answer 5