Comprehensive geriatric assessment generally includes evaluation of the patient in several domains, most commonly the physical, mental, social, economic, functional, and environmental.
It is conducted by a core team that consists, at a minimum, of a physician, nurse, and social worker, each with special expertise in caring for older people. Frequently, a psychiatrist is a member of the core team. The specific activities and contributions of each team member may vary considerably, and flexibility in roles may facilitate the assessment process.
The assessment begins with a case-finding approach that utilizes screening instruments and techniques. Based on these initial findings, a more detailed assessment is frequently undertaken. This in-depth assessment often requires the participation of a number of other professions. These may include audiology, clinical psychology, dentistry, nutrition, occupational therapy, optometry, pharmacy, physical therapy, podiatry, speech pathology, and the clergy. Support from other medical disciplines, such as neurology, ophthalmology, orthopedics, physiatry, surgery, and urology, is commonly needed.
Physical Health:A physical examination is performed with emphasis on identification of specific diseases or conditions for which curative, restorative, palliative, or preventive treatment may be available. Special attention is directed toward visual or hearing impairment, nutritional status, and conditions that may contribute to falling or difficulty in ambulation. Laboratory tests and other diagnostic studies are obtained as indicated.
Cognitive, behavioral, and emotional status are evaluated. Detection of dementia, delirium, and depression is particularly important. A range of assessment instruments is available for these purposes. For some patients a detailed psychiatric interview, a neurobehavior consultation, or comprehensive neuropsychological testing is indicated.
Social and Economic Status: