Comprehensive Geriatric Assessment (CGA): Past medical and surgical history

Most older people will be living with multimorbidity, defined as the co-existence of two or more long term health conditions.¹ Although multimorbidity is distinct from frailty, older people will often be living with both, with the accumulation of diseases and other deficits over time being related to the development and progression of frailty.

As people tend to acquire diagnoses as they get older, with ageing comes the increasing potential for diseases, impairments, and their treatments, to interact with each other. The resulting complexity is one of the key drivers behind the need for assessment processes that are comprehensive and holistic. For CGA to be tailored appropriately to an individual, a list of existing diagnoses should be drawn up, alongside any previous interventions that the person has undergone. It is important to be clear about which diagnoses are active, and which are in the past, and to make a co-ordinated onward plan for care there needs to be an understanding of the professionals and teams that are currently involved in helping the person to manage their health.

Within the surgical setting, there has been much research showing that those with frailty have poorer outcomes from surgical interventions,^2,3 but there is increasing evidence that these risks can be mitigated by the utilisation of CGA within the perioperative period.^4,5