Comprehensive Geriatric Assessment

Comprehensive geriatric assessment (CGA) forms the basis of the practice of geriatric medicine in all settings. The practice however hailed from humble beginnings and was promoted by pioneers such as Dr. Marjory Warren in the United Kingdom and Dr. Ignatz Nascher in the United States, who coined the term geriatrics, before any credible evidence as to the efficacy and cost-effectiveness of CGA. There is now considerable evidence to support the principles and practice of comprehensive geriatric assessment and geriatric evaluation and management (GEM). Whilst the application of CGA in the oldest old follows much of the same principles, its application in this population deserves special considerations, with less emphasis on prevention and more emphasis in advance care planning, end-of-life care and determination of appropriate medical intervention.