2017 Volume 2017 Issue 2 Pages 61
Aging is typically associated with multi-morbidity and complex health problems, including geriatric syndromes such as dementia, delirium, depression as well as visual and hearing impairment, falls, urinary and fecal incontinence and pressure ulcers. Problems are often underreported by the patient and unrecognized by the physician. Special attention is focused on frailty - a syndrome of decreased functional capacity and resistance to stressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability to adverse outcomes: disability, falls, multi-morbidity, hospitalization, institutionalization and mortality. Diagnostic information omitting analysis of functional relevance of the underlying conditions is of limited value. Social and environmental factors are also important, especially in older persons with functional impairment and dependency. Comprehensive geriatric assessment (CGA) is a method of complex examination of elderly patients and care planning. CGA involves the systematic evaluation of medical conditions, psychological parameters, functional status and socio-environmental networks. Our study demonstrated the rationale for including frailty examination in the CGA of geriatric inpatients. This diagnostic approach is realized by an interdisciplinary team consisting of a clinician (usually geriatrician), nurse, psychologist, physical/occupational therapist, social worker and other professionals according to the setting of the geriatric assessment. Validated measures are used to assess patient functional status. Studies comparing care based on the concept of the CGA with usual care showed benefits in terms of better patient outcomes and more efficient healthcare use.
