198 How comprehensive is our Comprehensive Geriatric Assessment in clinical practice?

Abstract

Abstract Background No gold standard exists for what should be included within a Comprehensive Geriatric Assessment (CGA). Consensus is that a CGA assessment should assess physical, functional, psychological and social well-being. We sought to examine the specific content of CGA that are being delivered across integrated care teams in Ireland. Methods We completed a cross sectional study of what domains are included in different integrated care CGA proformas. All operational leads for each integrated care hub were contacted and invited to share their local CGA. We examined what components across the domains of physical, psychological, functional and social assessment were included. Results We examined 16 different CGAs. The median length of a CGA was 14 pages (range: 4–28 pages). Common areas in all CGAs included assessments of frailty, cognition, mobility, falls, continence and social assessment, but there was variability in how these assessments were carried out. The Rockwood Clinical frailty scale the most common diagnostic tool for frailty (15/16 CGAs) with sarcopenia assessed in 75% of CGAs. The 4AT tool was used in 56% of CGAs, with a more detailed tool (e.g MMSE or MOCA) used in 56% of CGAs. Mood was assessed in 15 CGAs, sleep assessed in 10 CGAs and pain assessed in 7 CGAs. The widest variability was in the social assessment section with inconsistent assessments of caregiver strain (completed in 50%) and assessments of formal advanced care supports such as enduring power of attorney included in 44% of CGAs. Sexual health was not explicitly addressed in any CGA. Conclusion While there is considerable overlap with the core components of a CGA across integrated care sites there is significant variability across individual sites. Our results highlight the opportunity for consensus building across different integrated care teams to harmonise the delivery of CGA.