Chapter 2: Management of geriatric diseases and geriatric syndrome using comprehensive geriatric assessment (CGA): English translation of the Japanese CGA-based healthcare guidelines 2024

Abstract

Is CGA effective in frail older adults?

Statement: CGA is proposed to be performed on frail older adults.

Strength of evidence D.

Degree of recommendation 2 (weak) (agreement rate: 100%).

Are evaluations with assessment tools for “cognitive function” and “behavioral and psychological symptom (BPSD)” effective in the CGA for older adults with dementia?

Statement: The use of assessment tools of cognitive function or BPSD is recommended when performing CGA on older adults with dementia.

Strength of evidence C.

Degree of recommendation 1 (strong) (agreement rate: 88.9%).

Is CGA effective for older patients with polypharmacy?

Statement: Conducting CGA is proposed for older patients with polypharmacy.

Strength of evidence B.

Degree of recommendation 2 (weak) (agreement rate: 68.9%).

Is CGA effective for older patients with multimorbidity?

Statement: Performing CGA is recommended for older patients with multimorbidity.

Strength of evidence B.

Degree of recommendation 1 (strong) (agreement rate: 77.8%).

Is it effective to use CGA in the management of older patients with DM?

Statement: CGA is proposed in the management of older patients with DM.

Strength of evidence D.

Degree of recommendation 2 (weak) (agreement rate: 100%).

Is it effective to use CGA to evaluate older adults with hypertension or heart disease to determine a treatment plan?

Statement: CGA is proposed to evaluate older adults with hypertension or heart disease to determine a treatment plan.

Strength of evidence C.

Degree of recommendation 2 (weak) (agreement rate: 91.7%).

Is a multidisciplinary team approach based on CGA effective for treating pneumonia in older patients?

Statement: Regarding the effectiveness of a multidisciplinary team approach based on CGA for older patients with pneumonia, no evidence showed direct effects, but a multidisciplinary team approach that comprehensively understands the characteristics of older patients based on CGA is important, and we look forward to future research.

Is CGA screening effective for managing fractures in older adults?

Statement: Performing CGA is recommended in the management of older patients after fracture.

Strength of evidence B.

Degree of recommendation 1 (strong) (agreement rate: 90%).

Is it effective to use CGA to evaluate patients before surgery for gastrointestinal cancer, aortic disease, or heart disease in older adults?

Statement: Evaluation using CGA before surgery for gastrointestinal cancer, aortic disease, or heart disease in older patients is recommended.

Strength of evidence B.

Degree of recommendation 1 (strong) (agreement rate: 88.9%).

Is CGA effective in managing malignant tumors (systematic cancer therapy) in older patients?

Statement: CGA is recommended in the management of older patients with malignant tumors who are scheduled for systematic cancer therapy.

Strength of evidence A.

Degree of recommendation 1 (strong) (agreement rate: 100%).

HU received research funding from the following companies: Astellas Pharma, Abbott Japan, Eisai, MSD, Otsuka Pharmaceutical, ONO, Sanofi, Daiichi Sankyo, Sumitomo Pharma, Takeda, Mitsubishi Tanabe Pharma Chugai Pharmaceutical, Tsumura, Pfizer Japan., Fujifilm RI Pharma, Toyama Chemical., and Mochida Pharmaceutical. IS received research funding from Sompo Care. KT received honoraria from Pfizer Japan. SO received honoraria from Daiichi Sankyo. YT received honoraria from AstraZeneca, Kyowa Kirin, Daiichi Sankyo, Taiho Pharmaceutical, Takeda Pharmaceutical, Chugai Pharmaceutical, Bristol-Myers Squibb. MA received research funding from Astellas Pharma, Bayer Yakuhin, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Merck & Co., Fukuda Lifetech, Mitsubishi-Tanabe Pharma, Ono Pharmaceutical, Takeda, and Tsumura, and lecture fees from Daiichi Sankyo, Merck & Co., Toa Eiyo, and Towa Pharmaceutical. The other authors declare no conflict of interest.