Comprehensive geriatric assessment.
BACKGROUND
As an adjunct to the general and cancer-specific clinical and diagnostic examinations, comprehensive geriatric assessment (CGA) is an integral tool that examines factors affecting the course of disease and the outcome of treatment. The principal areas of focus of the CGA include the patient's functional, physical, mental, emotional, pharmacotherapeutic, and socioeconomic status.


METHODS
We describe the role of CGA in the identification and management of frail elderly patients. The literature is reviewed to outline the components, programmatic configurations, and process of CGA. Information from systematic reviews of clinical trials of different CGA program models is summarized, and observations relating to the research agenda concerning the applicability of CGA and CGA principles to management of older cancer patients are discussed.


RESULTS
Since age itself is not predictive of outcome in an elderly cancer patient, the CGA helps to distinguish between elderly patients who should be treated with intent to cure and those who will benefit from clinical oncologic and geriatric co-management.


CONCLUSIONS
A more accurate evaluation of prognostic indicators that includes CGA parameters could lead to a higher number of older patients being included in clinical cancer trials and being treated effectively in practice. It would also identify those who would benefit from gero-oncologic CGA and ongoing management aimed at maintaining function and community living.
Wieland
Darryl
D
Department of Medicine, University of South Carolina, Columbia 29204, USA. darryl.wieland@palmettohealth.org
Hirth
Victor
V
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006801:Humans; D009369:Neoplasms; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D014481:United States