From left, Dr. Melanie Liberty Alcausin, Institute of Human Genetics director; Dr. Leo Cubillanl, Philippine Eye Research Institute director; Dr Shelley dela Vega, Institute on Aging director and UPMWISE and FITforFrail Studies Project Director, and Dr. Erasmo Gonzalo Llanes, Philippine National Ear Institute director.
March 3, 2023 — Dr. Shelley Ann F. de la Vega, director of the UP Manila National Institutes of Health's (NIH) Institute on Aging (IA), presented at the Feb 27 NIH 25th anniversary conference the innovations of the Comprehensive Geriatric Assessment (CGA), which revealed the multi-faceted health issues confronting older people.
The CGA is an all-encompassing tool that can be used by any trained physician or health care practitioner. It is a comprehensive and thorough multidisciplinary interview-guided assessment that can unearth and provide a better picture of an older person’s physical, mental and social health issues. The 13-page comprehensive CGA checklist style evaluation form that can easily be completed by older persons is the core assessment tool the IA used in its UPWISE and FITforFrail Studies.
In 2012, while the Institute on Aging was still a study group, the CGA began with a tripartite workshop with the Philippine College of Geriatric Medicine, Department of Health (DOH) that included a rigorous en banc evaluation through various internal and external evaluation processes. The numerous inputs made by senior citizens in each conduct site have resulted in the current CGA.
Dr. Marissa Alejandria, Institute of Clinical Epidemiology director, Dr. Shelley dela Vega, and Dr. Eva Cutiongco-Dela Paza, NIH exec. director
These studies have generated information that has resulted in several international journal publications published papers and policy briefs with the DOH and partner agencies. As well as, served as a basis in formulating the recommendation of vaccination for older persons as part of the country’s COVID-19 pandemic response.
The CGA has 12 core domains of mostly geriatric syndromes that are amenable to interdisciplinary interventions such as functional capacity, fall risk, cognition, mood, polypharmacy, social support/living situation, financial concerns, nutrition/weight change, urinary continence, sexual function, vision/hearing, and dentition.
The CGA also reveals the underreporting of mental health related issues such as dementia, depression, sleep problems, as well as, fall risk, and incontinence. As a result, there is a need to improve research and service delivery and create a program that will offer a holistic solution to the problems facing our aging population.
The Significance of CGA
Prior to the introduction of CGA in the Philippines, the majority of doctors relied on MRI, CT scan, echocardiography, and patient interviews to identify patient disorders. Although these techniques are insightful, beneficial, and give accurate diagnosis, the CGA showed that a good number of geriatric syndromes are still under or unreported.
For older persons, cardiovascular diseases like hypertension, sensory system issues affecting vision and hearing, and endocrine issues like diabetes are the most frequently self-reported conditions. However, CGA evaluation studies reveal that presbyopia, cataract, and visual impairment are the number one problems for older persons. The CGA also reveals the underreporting of mental health related issues such as dementia, depression, sleep problems, as well as, fall risk, and incontinence. As a result, there is a need to improve research and service delivery and create a program that will offer a holistic solution to the problems facing our aging population.
January R. Kanindot