The role of the psycho-oncologist in the Comprehensive Geriatric Assessment (CGA)

The incidence of cancer increases dramatically with age and is reported to be 12 to 36 times higher in patients 65 years or older compared with those aged 25 to 44 years. The challenge for oncologists is to determine the optimum treatment for elderly patients. The Comprehensive Geriatric Assessment (CGA) is the main tool to take decisions in elderly patients diagnosed with cancer. And many screening tools have been tested to select which patients should be taken or not a complete CGA. Matters that influence geriatric assessment in the oncologic population will be highlighted in this article.

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10 Playing Our Part - Are The Occupational Therapists Completing A Comprehensive Geriatric Assessment?

Age and Ageing ◽

10.1093/ageing/afz103.05 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Paula Lavery ◽

Sinéad O'Connor

Keyword(s):

Older People ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Best Practice ◽

Occupational Therapists ◽

Initial Assessment ◽

Older Person ◽

Retrospective Audit ◽

Interdisciplinary Assessment

Abstract Background 10% of people over 65 years have frailty, rising to between a quarter and a half of those over 85. Comprehensive Geriatric Assessment (CGA) is the gold standard for the management of frailty in older people; it’s a process that involves a holistic, interdisciplinary assessment of the older person. Evidence shows that CGA is effective in improving outcomes for older people. The National Clinical Programme for the Older Person outlines the role of the occupational therapist in CGA. A clinical audit was completed to investigate whether the occupational therapists in the Medicine for the Older Person service are adhering to guidelines for CGA. Methods Following a literature review, a retrospective audit of occupational therapy (OT) initial assessments was completed using paper count method. Data pertinent to CGA OT assessment was collected. Audit results were presented to the OT team alongside a CGA education session. A re-audit was completed, using above methods. Results 10 inpatient initial assessment forms reviewed pre and post audit. Activities of Daily Living Assessment: Pre result: 60% Post Result: 90% Home Environment: Pre: 80% Post: 100% Performance Components Assessment: Vision: Pre: 90% Post: 100% Hearing: Pre: 80% Post: 100% Upper Limb: Pre: 70% Post: 100% Mood: Pre: 60% Post: 80% Cognition: Pre: 90% Post: 100% Sleep: Pre: 70% Post: 80% Social Assessment: Pre: 60% Post:90% Falls Assessment: Pre: 60% Post: 90% Drving: Pre: 60% Post: 90% Conclusion This audit identified that the occupational therapists in the medicine for the older person service were not CGA compliant. CGA training now forms an important part of our OT induction programme. We are now “playing our part” in CGA with improvements in all domains. CGA is now commonplace practice within our team, in line with international and national best practice guidance for management of frailty.

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Role of comprehensive geriatric assessment in low surgical risk older patients with aortic stenosis

Aging Clinical and Experimental Research ◽

10.1007/s40520-019-01228-0 ◽

2019 ◽

Vol 32 (3) ◽

pp. 381-388 ◽

Cited By ~ 1

Author(s):

M. Bo ◽

D. Bergamo ◽

E. Calvi ◽

M. Iacovino ◽

Y. Falcone ◽

...

Keyword(s):

Aortic Stenosis ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Older Patients ◽

Surgical Risk

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The role of comprehensive geriatric assessment and functional status in evaluating the patterns of antithrombotic use among older people with atrial fibrillation

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2016.04.008 ◽

2016 ◽

Vol 65 ◽

pp. 248-254 ◽

Cited By ~ 5

Author(s):

A. Mazzone ◽

M. Bo ◽

A. Lucenti ◽

S. Galimberti ◽

G. Bellelli ◽

...

Keyword(s):

Atrial Fibrillation ◽

Older People ◽

Functional Status ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment

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Tools For Decision-Making In Older Cancer Patients. Role Of The Comprehensive Geriatric Assessment

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520614999140416143258 ◽

2014 ◽

Vol 14 (5) ◽

pp. 651-656 ◽

Cited By ~ 5

Author(s):

M.J. Molina-Garrido ◽

C. Guillen-Ponce ◽

C. Castellano ◽

B. Errasquin ◽

A. Mora-Rufete ◽

...

Keyword(s):

Decision Making ◽

Cancer Patients ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Older Cancer Patients

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Ability of the Comprehensive Geriatric Assessment to Predict Frailty in Older People Diagnosed with Cancer in a General Hospital

European Oncology & Haematology ◽

10.17925/eoh.2012.08.02.85 ◽

2012 ◽

Vol 08 (02) ◽

pp. 85 ◽

Cited By ~ 1

Author(s):

Maria José Molina-Garrido ◽

Carmen Guillén-Ponce ◽

◽

Keyword(s):

General Hospital ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Daily Living ◽

Demographic Data ◽

Main Tool ◽

The Elderly ◽

Bivariate Analysis ◽

Bivariate Logistic Regression

The field of oncogeriatrics considers the comprehensive geriatric assessment (CGA) as the main tool for distinguishing between patients who are frail and those who are not frail. The aim of our study was to determine the role of the CGA in predicting the risk of frailty in elderly patients. This prospective study was conducted at the Cancer in the Elderly Unit of the Medical Oncology Department at the Virgen de la Luz General Hospital in Cuenca, Spain. Demographic data and information about the CGA were collected. Using a bivariate logistic regression analysis, these factors were analysed and the factors that are associated with the risk of frailty were determined, as measured by the Barber questionnaire (BQ). We included 262 patients in the study with a mean age of 79 years (range 7093 years). Seventy-four percent of the patients (n=194) had a risk of frailty as measured by the BQ. In the bivariate analysis, only age (odds ratio [OR] 1.064, 95 % confidence interval [CI] 1.0001.133, p=0.051), being divorced, widowed or single (OR 0.450, 95 % CI 0.2160.937, p=0.033) and being dependent in instrumental activities of daily living (IADL) (OR 3.003, 95 % CI 1.1817.638, p=0.021) were associated with a higher risk of frailty. The risk of being frail in an elderly patient with cancer is higher in patients dependent in IADL and in patients who are not married. Age is another risk factor for frailty.

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