Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Background
The Comprehensive Geriatric Assessment (CGA) systematically records geriatric syndromes to support individualized treatment and has been shown to improve functional outcomes and survival. A recent German S1 guideline for level 2 CGA recommends specific assessment instruments for each geriatric syndrome, but their actual use in routine clinical practice has not been systematically evaluated.

Methods
An online survey developed by an expert panel was distributed to all licensed geriatricians in Germany (n = 569). The survey covered assessment of motor function and self-help capability, cognition, depression, pain, dysphagia and nutrition, social status and comorbidity, pressure ulcers, language and speech, delirium, and frailty. Respondents reported which assessment instruments they routinely use.

Results
Of 122 respondents (21% response rate), 76 datasets were included in the analysis. All participants reported regular use of instruments assessing motor function, self-help capability, cognition, depression, and pain. The most frequently used tools were the Timed Up and Go (TUG), Barthel Index (BI), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Visual Analogue Scale (VAS). Assessment practices were limited or heterogeneous for delirium, frailty, and social status.

Conclusions
Assessment of motor function, self-help capability, cognition, depression, pain, and dysphagia and nutrition largely aligns with S1 guideline recommendations. However, instruments such as the Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and WHO-5 could be used more frequently. There remains a clear need for standardized assessment of delirium, frailty, and social status. Harmonizing assessment instruments across geriatric departments may improve treatment and prevention of age-related conditions.

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