Comprehensive Geriatric Assessment Flashcards
1
Q
What is the focus of a comprehenisve geriatric assessment (as opposed to a standard medical one)?
A
Functional rather than medical improvement is the focus
2
Q
What are some of the “giants” of geriatric medicine?
A
- Instability and falls
- Musculoskeletal problems, vestibular/cerebellar problems
- Immobility
- Pain, neurodegenerative diseases
- Incontinence
- Intellectual decline (delirium +/- dementia)
- Others - iatrogenesis, functional decline, pressure ulcers, dizziness
3
Q
How is frailty defined?
A
- Unintentional weight loss
- Weakness
- Exhaustion
- Slow waking speed
- Low physical activity
- 3+ = frail, 1-2 = pre-frail
4
Q
Describe which populations most benefit from a comprehensive geriatric assessment
A
- People with low functional reserve or high levels of frailty, that aren’t too ill in a medical sense or too well to benefit
- Recent onset of physical impairment/cognitive, or changing status
- Multiple interacting treatable problems
- Fragmented specialist care
- Disorders requiring rehabilitation
- Consideration of living situation change
- Competency/capacity/medicolegal issues
5
Q
Describe the key domains of a comprehensive geriatric assessment
A
- Medical
- Problem list, medication review, nutrition/dental
- Physical and functional
- ADLs (pADLs and iADLs), balance, continence, gait
- Neuropsychological
- Cognition and mood (CAM, MMSE, GDS)
- Social
- Living arrangements and supports
- Economic
- Environmental
- Home safety, transport
- Support