Comprehensive geriatric assessment (CGA) for cancer patients

Abstract

Chronologic age alone is a poor descriptor of heterogeneity in the aging process and is an inadequate indicator to determine responses among older patients to cancer treatment. Geriatric conditions such as functional and cognitive impairments are frequently unrecognized or inadequately addressed in older adults. Identifying geriatric conditions by performing a geriatric assessment can help clinicians manage these conditions and prevent or delay their complications. A comprehensive geriatric assessment (CGA) includes evaluation of an older individual’s functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support, as well as a review of the patient’s medications. Multiple studies have shown the benefits of utilization of CGA in older cancer patients. Administering a CGA may not be practical in all clinical settings. Screening tools may be considered initially keeping in mind that they do not replace CGA. If abnormal, screening should be followed by CGA and guided multidisciplinary interventions. This chapter will describe the CGA domains, the most commonly used assessment tools, as well as the benefits of performing such assessments in the older cancer patients.