Lecture 2- Comprehensive Geriatric Assessment (CGA) Flashcards Preview

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Flashcards in Lecture 2- Comprehensive Geriatric Assessment (CGA) Deck (15):

What is the value of CGA

- Improves function
- Improves Health Quality of Life
- Decrease Hospitalizations


How to conduct office-based assessment (what should you do?)

- Functional assessment by observation
- Directed medical history and physical examination
- Assessment instruments/tools
- Psychological assessment


Functional assessment by observation

- Did the patient fill out the questionnaire?
- Observe the patient walk and getting on exam table
- What kind of detail does the pt. give you in a history?


What to include in Directed medical history and physical exam

- IADL (instrumental activities of daily living)
- Vision
- Hearing
- Weight/Nutrition
- Gait and balance/feet


What are the IADL's, and when do you start asking about them?

- Community dwelling, and 65 and older- begin asking
- Follow up at 1,3,5 yr....

The four IADLS
- Telephone
- Transportation
- Medications
- Finances


What percentage of the elderly have a nutritional disorder?



Serum _______ and _______, although nonspecific, are prognostic factors for mortality

Albumin, cholesterol


Weight loss of more than _______ total body weight in the past 6 months is a RED FLAG



How do you test gait, balance, feet in the CGA?

- The get up and go test!
- walk 10 ft and return to chair
- Fail if it takes more than 20 seconds.


How should you do psychosocial assessment in a CGA?

- Cognitive Testing
- Mood/Depression testing

- be familiar with the risk factors for depression- esp. social isolation.---- does this patient apply to any of those?


2 geriatric screeners for depression

- Geriatric Depression Scale (GDS)
- Patient Health Questionnaire (PHQ-9)


What can you use for Cognitive Function assessment?

- Folstein mini-mental state examination (MMSE)
- Montreal cognitive assessment (MOCA)
- Clock draw test (CDT)
- Verbal fluency (VF) or animal naming
- Mini-Cog (3 item recall test and clock draw)


What can you use for palliative/performance status assessment?

-Karnofsky scale (0-100 scale, with normal being 80 and above)
- Palliative Performance scale, version 2 (PPSv2)


CGA Definition

- A multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of an older adult in order to develop a coordinated plan to maximize overall health with aging


IADL's as a predictor of dementia

- the odds ratio for getting dementia goes up as you have more issues with IADL's

1 IADL lost- OR- 1.00
2 IADL lost- OR- 2.34
3 IADL lost- OR - 4.54