A geriatric assessment evaluates medical, social, and environmental factors that influence overall well-being, and addresses functional status, fall risk, medication review, nutrition, vision, hearing, cognition, mood and toileting. It also includes discussion, development and implementation of a care plan, with monitoring and revisions as needed. Immunizations and advance care planning are also crucial components of the geriatric assessment.
The Medicare Annual Wellness Visit includes the key elements of geriatric assessment performed by physicians.
Deeper dive
According to the American Association of Family Physicians, a comprehensive geriatric assessment can help physicians recognize problems that impair quality of life sooner, by identifying areas for focused intervention. AAFP also suggests a rolling geriatric assessment over several visits, which can also effectively identify subtle or hidden problems. Assessment should be tailored to patient goals of care and life expectancy.
AAFP recommends screening for:
- Depression: When depression care supports are available; this is performed with a brief two-item patient health questionnaire.
- Unintentional weight loss and malnutrition: The causes of these issues vary, but both can lead to increased illness or death. Acute or chronic illness, medication side effects, and social factors like isolation or financial problems can all contribute to poorer diet and weight loss.
- Hearing loss: There is not enough evidence to recommend screening in asymptomatic people, although rates of hearing loss and vision loss increase with age.
- Cognition: The U.S. Preventive Services Task Force now advises clinicians to assess cognition when there is suspicion of impairment.
- Urinary incontinence: This is another age-related concern that can impair patients’ quality of life; it can be assessed with a two-question screening tool.