Comprehensive Geriatric Assessment (CGA) Flashcards
What are the 5 components of a CGA?
Medical Psychological Functioning Social/environment Spiritual
What constitutes the medical component of a CGA?
Problem list
Co-morbid conditions and disease severity
Medication review
Nutritional status - MUST
What constitutes the functioning component of a CGA?
Basic ADLs
Extended ADLs
Activity/exercise status
Gait and balance
What constitutes the psychological component of a CGA?
Mental status/ cognitive
Mood/depression
What constitutes the social/environment of a CGA?
Informal needs and assets
Social circle
Care resource eligibility and resources
Saftey
What are the frailty syndromes?
Off legs Falls Confusion Frailty Continence issues Polypharmacy
What are the proven benefits of a CGA in a dedicated assessment unit?
Reduces mortality at 6 months Improves function Improves cognition Reduces need for nursing home care (NNT = 33) Reduces subsequent hospital admission
Describe the differences of acute illness in older people
Atypical or masked presentations may delay diagnosis or lead to the wrong diagnosis
Pathophysiology response varies
Immune response may vary with disease/drugs/nutrition
Co-morbid conditions increase need to be co-managed
Ix and Mx need to be tailored
Meds to be reviews
Common complications of anti-platelets in older people
Upper GI bleeding
Hemorrhagic stroke
Falls; epidural bleed
Describe the difference in the pathophysiology of stroke in the older population
BP may drop - esp in those on vasodilating antihypertensives (ACEi)
Temp low not high
No tachycardia due to beta blockers
Delirium
CRP and WCC may not rise
Fluid balance hard - heart failure and kidneys; do a fluid challenge
Antibiotics NOT broad spectrum due to c.diff
4 antibiotics of c.diff
Ciprofloxacin (all quinolones)
Clindamycin
Co-amoxiclav
Cephalosporins
