Geriatric Assessment Overview

Geriatric Assessment

• Aims: to recognize common geriatric disorders, plan effective treatment programs, improve overall health and functional outcomes, reduce vulnerability to subsequent illness, and improve quality of life.
• Function: Physical function (gait and balance, self-care), cognitive function (memory, reasoning, judgment, life-maintenance), psychosocial function (depression, mental health, caregiver support, financial resources).
• Instrumental Activities of Daily Living (IADLs): Shopping, housekeeping, accounting, food prep, transportation.
• Activities of Daily Living (ADLs): Dressing, eating, ambulating, toileting, hygiene, bathing
• Importance of ADLs/IADLs: predict hospital outcomes, functional decline, length of stay, institutionalization.
• Assessment: functional tasks (walking, dressing), standardized tests, performance-based testing
• Best test: a "real world" performance test is easy to perform in an office setting and evaluate.

Timed "Get Up and Go" Test

• Patient sits in a chair, rises, walks 10 feet, turns, returns to chair.
• < 20 seconds is considered normal, > 30 seconds indicates functional dependence.
• High risk for falls.

Chair Rise Test

• Standard chair with arms.
• Patient rises from the chair without support.
• <15 seconds for 5 repetitions is normal.

Cognitive Evaluation

• Prevalence of cognitive impairment: 3% at 65, doubling every 5 years.
• Causes of cognitive impairment: delirium, dementia, depression.

Mini-Cog Test

• 3-item recall after clock drawing task.
• Easy to administer with high sensitivity and specificity.
• Not as dependent on education or language.

Clock Drawing Test

• Test for cognitive impairment.
• Assess recall and cognitive speed with 3 items.

Depression Screening

• Single question: "Do you often feel sad or depressed?"
• 2-item screening assesses depressed mood and anhedonia (lack of interest or pleasure in activities).
• Geriatric Depression Scale (GDS) screen for depression, with >5 points suggesting possible depression.

Geriatric Assessment - Other Information

• Folstein Mini-Mental State Exam: (MMSE) a 30-point questionnaire used to screen for cognitive impairment.
• Interpretation of Scores: Scores <24 are considered abnormal.
• Risk for Falls: factors like leg weakness, gait deficit are associated with increased fall risk. A relative risk score for each is given.

This quiz focuses on the key aspects of geriatric assessment, including the recognition of common disorders, the evaluation of physical, cognitive, and psychosocial functions, and the significance of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Participants will learn about assessment methods and the importance of functional outcomes to enhance the quality of life for older adults.