Comprehensive Geriatric Assessment (CGA) Screening of Geriatric Patients in a Tertiary Care Hospital: a Cross-sectional Study in India

ABSTRACT

Background: Within the next few decades, India will witness a staggering increase in its elderly population owing to advancements in health care. However, an increase in life span is not mutually inclusive with high quality of living. Old age is associated with multiple ailments which decreases functionality and increases dependency, several of which go undiagnosed while catering to primary complaints. This prompts the need for a comprehensive approach to the healthcare of the elderly for which Comprehensive Geriatric Assessment (CGA is widely practiced in the west. Objectives: This study was conducted to estimate the prevalence of undiagnosed medical problems by Comprehensive Geriatric Assessment (CGA) Screening and explore its applicability in Indian tertiary healthcare setup. Methodology: Following ethical approval of the institute, a cross-sectional study was conducted among 262 geriatric patients with age over 60 years, from seven out-patients departments. A Comprehensive Geriatric Assessment (CGA) inventory was prepared by compiling screening instruments for Visual acuity, Hearing acuity, Dependency, Functionality, Depression, Cognitive impairment, Fall risk, Urinary incontinence, Nutritional Status and Insomnia. The participants were administered the screening inventory once they had already undergone a normal check-up in the OPDs. Results: Overall, 262 geriatric patients underwent CGA screening (Female 57.3%, Male 42.7%). There was a high prevalence of problems going undiagnosed ranging from 58.65% to 95.45% in various OPDs. Some problems had a significantly greater overall prevalence and were also prevalent in going undiagnosed in particular OPDs (urinary incontinence in Gynaecological OPD, p=0.003; insomnia in surgical OPD, p<0.005). Many patients who screened positive for certain problems were found to have a few other problems as well (dependency and cognitive impairment, p=0.003; insomnia and depression, p=0.0001). Conclusion: This study showed a high prevalence of problems going undiagnosed along with their associations with particular OPDs and other problems. Participants of this study showed a considerable acceptability for CGA. This reaffirmed the need for CGA in every geriatric patient in our tertiary care setup.