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Comprehensive geriatric assessment: Benefits and limitations

Published:February 19, 2018DOI:https://doi.org/10.1016/j.ejim.2018.02.016
      The traditional disease-oriented model of medicine focuses on the theory that organ- or system-based pathologies cause disease and, thus, treatment is focused on eliminating the underlying pathology. However, the disease model does not account for complexity of patients that are more often being seen in modern medical settings [
      • Tinetti M.E.
      • Fried T.
      The end of the disease era.
      ]. Due to increasing life expectancy, health care systems are progressively facing growing populations of older patients, who often have non-disease specific problems such as multimorbidity, frailty, polypharmacy, and disability [
      • Marengoni A.
      • Angleman S.
      • Melis R.
      • Mangialasche F.
      • Karp A.
      • Garmen A.
      • et al.
      Aging with multimorbidity: a systematic review of the literature.
      ,
      • Soong J.
      • Poots A.J.
      • Scott S.
      • Donald K.
      • Woodcock T.
      • Lovett D.
      • et al.
      Quantifying the prevalence of frailty in English hospitals.
      ]. The comprehensive geriatric assessment (CGA) and Management is an approach that aims to overcome some of the limitations of the disease-oriented model. Generally defined, CGA is a multi-dimensional multi-disciplinary diagnostic process focused on assessing an older person's medical, psychological and functional capability in order to develop a coordinated and integrated plan for treatment and long-term follow-up focused on the individual's needs. This assessment is followed by the development of a care plan, based upon the comprehensive assessment. The care plan must state explicitly what goals are being aimed for, who is responsible for achieving them and a timeline for review of progress.

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