Ramona S. Pungutan,
Miguel A. Ramos Related Institution
Journal Article, Original
Philippine Journal of Internal Medicine
Date of Publication
BACKGROUND: In the advent of the growing aging population, much health care services and clinical research has sought to define the healthcare delivery modalities and specific interventions that would address specific problems in the elderly. The complete geriatric assessment has been central to the approach since it contains the traditional medical history and incorporates additional information assessing geriatric specific issues. Comprehensive geriatric assessment (CGA) is defined as a multidimensional medical, functional, psychosocial and environmental evaluation of an older person's problems and resources, linked with an overall plan for treatment and follow-up. In the clinical context, CQA is used to identify functional problems and disabilities of older patients with the aim of providing care and arranging longer-term follow-up.
OBJECTIVES: This study was conducted to determine the yield of utilizing the complete geriatric assessment (CQA) as a diagnostic screening tool in the hospital setting and to identify the geriatric syndromes that are commonly missed with the use of traditional medical history and physical examination.
METHODOLOGY: This is a prospective study involving 40 patients admitted at St. Luke's Medical Center from January 2005 to January 2006. All 40 patients were interviewed and examined by the Geriatric medicine fellow using the CQA on admission and was compared with traditional medical history, physical exam and diagnosis of admitting medical resident and confirmed by attending consultant.
RESULTS: The use of CQA yielded identification of mild cognitive impairment (5 percent), cases of malnutrition (7 percent), depression (20 percent), polypharmacy (25 percent), deficiencies in vaccination for pneumonia and influenza (30 percent), dementia (37 percent), at risk for fall (40 percent), at risk for malnutrition (40 percent), and impairment in the instrumental and activities of daily living (45 percent). CONCLUSION: CQA implemented in a specialized geriatric center, St. Luke's Medical Center yields detection of specific geriatric syndromes which are often missed when using a traditional medical history and physical exam. References
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