Skip to main content
SpringerLink
Log in

Comprehensive Geriatric Assessment

  • Chapter
  • First Online:
Geriatric Psychiatry

  • 244 Accesses

Abstract

This chapter focuses on the approach to comprehensive geriatric assessment and is not intended to be a comprehensive review of medical diagnosis and treatment. For this the reader is encouraged to consult a textbook of internal medicine or geriatrics. The amount of workup and management of systemic medical complaints should be tailored to the psychiatrist’s level of comfort in this role, as well as the skills and comfort of staff to carry out needed monitoring and treatment. A patient’s functional status (i.e., their ability to perform basic, instrumental, and advanced activities of daily living) represents a core component of a person’s identity and self-worth. For the psychiatrist, understanding the patient’s functional and psychosocial status in addition to underlying systemic medical conditions furnishes the context in which psychiatric morbidity takes place and informs the development of the medical and nonmedical components of the treatment plan. An older adult’s functional status too often is the unrecognized collateral damage of chronic systemic medical and psychiatric illness. Not only can it influence the expression and severity of psychiatric morbidity, but it can also be directly affected by the treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Briggs R, McDonough A, Ellis G, Bennett K, O'Neill D, Robinson D. Comprehensive geriatric assessment for community-dwelling, high-risk, frail, older people. Cochrane Database Syst Rev. 2022;5(5):Cd012705.

    PubMed  Google Scholar 

  2. Devons CA. Comprehensive geriatric assessment: making the most of the aging years. Curr Opin Clin Nutr Metab Care. 2002;5(1):19–24.

    Article  PubMed  Google Scholar 

  3. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970;10(1):20–30.

    Article  CAS  PubMed  Google Scholar 

  4. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.

    Article  CAS  PubMed  Google Scholar 

  5. Miller KE, Zylstra RG, Standridge JB. The geriatric patient: a systematic approach to maintaining health. Am Fam Physician. 2000;61(4):1089–104.

    CAS  PubMed  Google Scholar 

  6. Michikawa T. Prevalence, adverse health, and risk factors in association with sensory impairments: data from a prospective cohort study of older Japanese. Environ Health Prev Med. 2016;21(6):403–9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Pirozzo S, Papinczak T, Glasziou P. Whispered voice test for screening for hearing impairment in adults and children: systematic review. BMJ. 2003;327(7421):967.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mansuri Z, Patel K, Shah B, Trivedi C, Adnan M, Vadukapuram R, et al. Charles bonnet syndrome: a case report and review of the literature. J Nerv Ment Dis. 2022;210(11):880–2.

    Article  PubMed  Google Scholar 

  9. Hamedani AG. Vision loss and hallucinations: perspectives from neurology and ophthalmology. Curr Opin Neurol. 2021;34(1):84–8.

    Article  PubMed  Google Scholar 

  10. Russell G, Burns A. Charles bonnet syndrome and cognitive impairment: a systematic review. Int Psychogeriatr. 2014;26:1–13.

    Article  Google Scholar 

  11. Milsom I, Gyhagen M. The prevalence of urinary incontinence. Climacteric. 2019;22(3):217–22.

    Article  CAS  PubMed  Google Scholar 

  12. Jumadilova Z, Zyczynski T, Paul B, Narayanan S. Urinary incontinence in the nursing home: resident characteristics and prevalence of drug treatment. Am J Manag Care. 2005;11(4 Suppl):S112–20.

    PubMed  Google Scholar 

  13. Hansson Vikström N, Wasteson E, Lindam A, Samuelsson E. Anxiety and depression in women with urinary incontinence using E-health. Int Urogynecol J. 2021;32(1):103–9.

    Article  PubMed  Google Scholar 

  14. Lagana L, Bloom DW, Ainsworth A. Urinary incontinence: its assessment and relationship to depression among community-dwelling multiethnic older women. Sci World J. 2014;2014:708564.

    Article  Google Scholar 

  15. Sandvik H, Hunskaar S, Seim A, Hermstad R, Vanvik A, Bratt H. Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey. J Epidemiol Community Health. 1993;47(6):497–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Resnick NM. Improving treatment of urinary incontinence. JAMA. 1998;280(23):2034–5.

    Article  CAS  PubMed  Google Scholar 

  17. Weiss BD. Diagnostic evaluation of urinary incontinence in geriatric patients. Am Fam Physician. 1998;57(11):2675–84; 88–90

    CAS  PubMed  Google Scholar 

  18. Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58(9):1734–8.

    Article  PubMed  Google Scholar 

  19. Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guerin O, et al. Frailty and nutrition: searching for evidence. J Nutr Health Aging. 2015;19(3):250–7.

    Article  CAS  PubMed  Google Scholar 

  20. Araujo JR, Martel F, Borges N, Araujo JM, Keating E. Folates and aging: role in mild cognitive impairment, dementia and depression. Ageing Res Rev. 2015;22:9–19.

    Article  CAS  PubMed  Google Scholar 

  21. Volkert D, Chourdakis M, Faxen-Irving G, Fruhwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34(6):1052–73.

    Article  PubMed  Google Scholar 

  22. Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The mini nutritional assessment. Clin Geriatr Med. 2002;18(4):737–57.

    Article  PubMed  Google Scholar 

  23. Seppala LJ, Wermelink A, de Vries M, Ploegmakers KJ, van de Glind EMM, Daams JG, et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics J Am Med Dir Assoc. 2018;19(4):371.e11–7.

    Article  PubMed  Google Scholar 

  24. Brignole M. Distinguishing syncopal from non-syncopal causes of fall in older people. Age Ageing. 2006;35 Suppl 2:ii46–50.

    Article  PubMed  Google Scholar 

  25. Marcum ZA, Amuan ME, Hanlon JT, Aspinall SL, Handler SM, Ruby CM, et al. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2012;60(1):34–41.

    Article  PubMed  Google Scholar 

  26. Messerli FH. Osler's maneuver, pseudohypertension, and true hypertension in the elderly. Am J Med. 1986;80(5):906–10.

    Article  CAS  PubMed  Google Scholar 

  27. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale Lancet. 1974;2(7872):81–4.

    CAS  PubMed  Google Scholar 

  28. Growdon ME, Schultz AP, Dagley AS, Amariglio RE, Hedden T, Rentz DM, et al. Odor identification and Alzheimer disease biomarkers in clinically normal elderly. Neurology. 2015;84(21):2153–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Erdinest N, London N, Lavy I, Morad Y, Levinger N. Vision through healthy aging eyes. Vision (Basel). 2021;5(4):46.

    Article  PubMed  Google Scholar 

  30. Owsley C. Aging and vision. Vis Res. 2011;51(13):1610–22.

    Article  PubMed  Google Scholar 

  31. Singh A, Deshmukh P. Bell's Palsy: a review. Cureus. 2022;14(10):e30186.

    PubMed  PubMed Central  Google Scholar 

  32. Caviness JN, Brown P. Myoclonus: current concepts and recent advances. Lancet Neurol. 2004;3(10):598–607.

    Article  PubMed  Google Scholar 

  33. Agarwal R, Baid R. Asterixis. J Postgrad Med. 2016;62(2):115–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Ellul MA, Cross TJ, Larner AJ. Asterixis. Pract Neurol. 2017;17(1):60–2.

    Article  PubMed  Google Scholar 

  35. Elias WJ, Shah BB. Tremor Jama. 2014;311(9):948–54.

    Article  CAS  PubMed  Google Scholar 

  36. Walker RH. Chorea. Continuum (Minneapolis, Minn). 2013;19(5 Movement Disorders):1242–63.

    PubMed  Google Scholar 

  37. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34(2):119–26.

    Article  CAS  PubMed  Google Scholar 

  38. Limpawattana P, Phungoen P, Mitsungnern T, Laosuangkoon W, Tansangworn N. Atypical presentations of older adults at the emergency department and associated factors. Arch Gerontol Geriatr. 2016;62:97–102.

    Article  PubMed  Google Scholar 

  39. Yahav D, Schlesinger A, Daitch V, Akayzen Y, Farbman L, Abu-Ghanem Y, et al. Presentation of infection in older patients--a prospective study. Ann Med. 2015;47(4):354–8.

    Article  PubMed  Google Scholar 

  40. Aronow WS, Mercando AD, Epstein S. Prevalence of silent myocardial ischemia detected by 24-hour ambulatory electrocardiography, and its association with new coronary events at 40-month follow-up in elderly diabetic and nondiabetic patients with coronary artery disease. Am J Cardiol. 1992;69(5):555–6.

    Article  CAS  PubMed  Google Scholar 

  41. Kenney WL, Chiu P. Influence of age on thirst and fluid intake. Med Sci Sports Exerc. 2001;33(9):1524–32.

    Article  CAS  PubMed  Google Scholar 

  42. Magkas N, Tsioufis C, Thomopoulos C, Dilaveris P, Georgiopoulos G, Sanidas E, et al. Orthostatic hypotension: from pathophysiology to clinical applications and therapeutic considerations. J Clin Hypertens (Greenwich). 2019;21(5):546–54.

    Article  PubMed  Google Scholar 

  43. Ricci F, De Caterina R, Fedorowski A. Orthostatic hypotension: epidemiology, prognosis, and treatment. J Am Coll Cardiol. 2015;66(7):848–60.

    Article  PubMed  Google Scholar 

  44. Campos AC, de Almeida NA, Ramos AL, Vasconcelos DF, Freitas MP, de VTMA. Orthostatic hypotension at different times after standing erect in elderly adults. J Am Geriatr Soc. 2015;63(3):589–90.

    Article  PubMed  Google Scholar 

  45. Paley L, Zornitzki T, Cohen J, Friedman J, Kozak N, Schattner A. Utility of clinical examination in the diagnosis of emergency department patients admitted to the department of medicine of an academic hospital. Arch Intern Med. 2011;171(15):1394–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  2. McMaster University, Centre for Healthy Aging, St. Peter’s Hospital, Hamilton, ON, Canada

    Tricia K. W. Woo

Authors
  1. Calvin H. Hirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tricia K. W. Woo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Calvin H. Hirsch .

Editor information

Editors and Affiliations

  1. Division of Geriatric Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    Caroline Giroux

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hirsch, C.H., Woo, T.K.W. (2024). Comprehensive Geriatric Assessment. In: Hategan, A., Bourgeois, J.A., Hirsch, C.H., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-47802-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-47802-4_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-47801-7

  • Online ISBN: 978-3-031-47802-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation