What a Comprehensive Geriatric Assessment is, and why it changes treatment

The problem with treating one disease at a time

A 78-year-old with diabetes, high blood pressure, arthritis and trouble sleeping usually ends up with four doctors, four plans and fourteen medications. Each specialist does their part well, but nobody looks at the whole.

The result is familiar: instructions that contradict each other, drugs that pile up because no one takes them away, and a person who feels worse while their tests "come back fine". Geriatrics exists precisely to solve that.

The five dimensions evaluated

The assessment covers the medical (diagnoses, examination, tests), but it also measures four things no other visit measures systematically: function, cognition, mood and the social setting.

Function is explored with simple tests: how you get up from a chair, how you walk, whether you can bathe, cook or handle your money alone. Cognition, with brief memory, attention and language tests. Mood, with scales designed for older adults. And the setting: who provides care, with what support and in what home.

Added to that is a review of nutrition, sleep, continence, vision, hearing and, item by item, every medication.

Why the resulting plan is different

When those five dimensions come together, the priorities change. It may turn out that the most urgent thing is not lowering the A1C, but withdrawing the drug causing dizziness, treating the depression the family was reading as dementia, and starting strength exercise so there is not another fall.

That is the real value: not more testing, but better decisions. A plan the person and their family understand, with reachable goals and a clear order.

When to ask for an assessment

There is no need to wait for a crisis. It is especially useful from age 60, or earlier if there are several conditions, memory problems, falls or loss of independence. Also before scheduled surgery and after any hospital stay.