Comprehensive Geriatric Assessment
| Component | Tool | Example intervention |
|---|---|---|
| Comorbidity | Full history and itemised optimisation | Optimisation of cardiac, respiratory, renal disease, diabetes. |
| Medication | Medication review | Rationalisation; STOPP-START criteria |
| Nutrition | Modified MUST tool | Nutritional optimisation; dietician referral |
| Exercise tolerance | Metabolic Equivalents Scale | Prehabilitation programme |
| Cognition | Montreal Cognitive Assessment | Delirium risk reduction protocols |
| Frailty | Reported Edmonton Frail Scale | Multicomponent CGA intervention |
| Mood | Depression question; global assessment | Antidepressants; referral to clinical psychology |
| Functional capacity | Nottingham Extended Activities of Daily Living | Social services referral |
| Social circumstances | Housing, support network, existing care arrangements | Social services referral |
| Discharge plan | Identification of borough, rehabilitation facilities and access to social services support. Explanation to patient and family | Early OT and Physiotherapy referral |
| Screening investigations (where indicated) | FBC, renal, liver, bone, thyroid profiles, haematinics, Vitamin D, ECG, CXR, BNP, HbA1c. | Diagnosis of medical comorbidity and preoperative optimisation |
BNP = brain natriuretic peptide; CGA = Comprehensive Geriatric Assessment; CXR = chest X-ray; ECG = electrocardiogram; FBC = full blood count; HbA1c = haemoglobin A1c; MUST = malnutrition universal screening tool; OT = occupational therapist; STOPP-START = Screening Tool of Older Person's Prescriptions – Screening Tool to Alert doctors to Right Treatment