CGA

Question 1

What is a CGA?

Answer 1

• A multidimensional, interdisciplinary diagnostic process…
• focused on determining a frail elderly person’s medical, psychological and functional capability…
• in order to develop a coordinated and integrated plan for treatment + long-term follow up.

Question 2

Name advantages and disadvantages of the CGA.

Answer 2

Advantages:

1. reduces mortality (NNT 17 to avoid 1 death at 6/12)
2. people more likely to remain active + less dependent (compared to standard Tx of presenting complaint)

Disadvantages:

1. only effective when whole MDT involved
2. time-consuming

Question 3

Describe the 4 main types of incontinence seen in elderly people. How would they present?

Answer 3

1. Stress
   - incompetence of urethral sphincter, usually due to positional displacement/herniation
   - leakage during physical activity or with increased intra-abdo pressure
2. Urge
   - uncontrolled detrusor activity
   - urgency followed by leakage, frequency, nocturia
3. Overflow
   - outflow obstruction or bladder overdistension causing impaired detrusor contractility
   - dribbling, hesitancy, inability to empty bladder
4. Functional
   - inability to reach/use/request appropriate receptacle
   - variable