At a glance
A Comprehensive Geriatric Assessment (CGA) is a structured evaluation that looks at the whole health picture of an older adult, not just one illness at a time. A geriatrician (a doctor specialised in the care of older people) leads a team that may include a nurse, physiotherapist, dietitian, and social worker, each examining a different part of the patient's wellbeing.
The team checks physical health, brain function, mood, the ability to manage daily tasks, medications, nutrition, and home situation. The goal is to find problems that a standard appointment might miss, then draw up a single care plan that addresses all of them together.
Medical Condition
A CGA is recommended when an older adult's health situation is complicated enough that a single-specialist visit would leave important questions unanswered. Doctors typically request it when several health problems overlap, when function is declining, or before a major treatment decision.
- Multiple long-term illnesses occurring at the same time (for example, diabetes alongside heart disease and arthritis)
- Unexplained weight loss, repeated falls, or growing difficulty with daily tasks such as dressing or cooking
- Confusion or memory changes that need to be assessed (possible dementia or delirium)
- Low mood or withdrawal from social activities in an older person
- A complex medication list (polypharmacy), especially when side effects are suspected
- Planning for a major surgery or cancer treatment, to check whether the patient can tolerate it
- Discharge planning after a hospital stay, to arrange the right level of support at home
- Frailty (a state of reduced body reserve where small stresses cause large setbacks)
A CGA is not the right first step for every older adult. Patients who are generally well, independent, and have straightforward medical needs are usually better served by a routine check-up with their regular doctor.
- Older adults who are fully independent with no functional decline
- Patients whose main problem has a clear single cause already identified
- Situations where the patient or family declines further assessment
Risks & Complications
A CGA is a non-invasive (no cuts, needles, or equipment entering the body) assessment, so it carries almost no physical risk. The process does involve some considerations worth knowing about.
- Fatigue: the assessment can last several hours across one or more sessions, which may tire an older or frail patient
- Emotional distress: questions about memory, mood, independence, and end-of-life preferences can be upsetting for some patients or family members
- Incidental findings: the team may discover a serious problem the patient was unaware of, which, while medically useful, can cause anxiety
- Blood or imaging tests ordered as part of the assessment carry their own small risks (bruising from a blood draw, radiation from an X-ray), which the relevant team member will explain before proceeding
Preparation & Procedure
Because a CGA involves no surgery or anaesthesia (medication that makes you unconscious), fasting is not required. Patients should take their regular medications on the morning of the assessment unless their doctor says otherwise.
Bringing the following items makes the assessment more efficient and accurate. The team can only work with the information they have, so gathering these in advance saves time.
- A complete and up-to-date list of all medications, including vitamins, herbal supplements, and over-the-counter drugs, with the doses currently being taken
- All recent test results, scan reports, discharge letters, and clinic letters from the past one to two years
- Government-issued identification and insurance documents
- A trusted family member or caregiver who knows the patient's day-to-day function and history, as their observations are part of the assessment
If blood tests, an EKG (a recording of the heart's electrical activity), urine tests, or imaging such as a chest X-ray are planned as part of the assessment, these are usually arranged on the same day or in a separate appointment before the main session.
The assessment itself unfolds in a series of conversations and simple tasks rather than one long test. The order and number of steps vary between hospitals, but a typical session includes the following.
- 1. A medical history interview covering current problems, past illnesses, surgeries, allergies, and family history
- 2. A physical examination, including blood pressure, heart rate, weight, height, and a check of the main body systems
- 3. A cognitive test (a structured set of questions and tasks that measures memory, attention, and problem-solving)
- 4. A mood and depression screening, usually through a short questionnaire
- 5. A functional assessment, checking which daily activities the patient can do alone and which require help
- 6. A gait and balance test, often involving walking a short distance or standing from a chair
- 7. A nutrition screen, including body weight, eating habits, and any swallowing difficulties
- 8. A medication review to look for interactions, inappropriate doses, or drugs that are no longer needed
- 9. A social assessment covering living situation, carer support, finances, and personal wishes
- 10. A team meeting to bring findings together and draft a care plan
Aftercare
Because no procedure enters the body, there is no wound to care for and no physical recovery period after a CGA. The follow-up work, however, is where much of the value lies. Acting on the care plan is what makes the assessment useful.
- A written summary or report is usually provided within a few days to a week, depending on how many specialists contributed
- Follow-up appointments will be scheduled with the relevant specialists identified during the assessment, such as a neurologist for memory concerns or a cardiologist for heart issues
- Medications may be adjusted, stopped, or added based on the medication review; a pharmacist or geriatrician will explain any changes
- Physiotherapy (physical exercise treatment) or occupational therapy (training to regain daily skills) sessions may be recommended and should begin as soon as possible
- Home modifications, such as grab rails or a raised toilet seat, may be suggested to reduce fall risk
- Nutrition support, such as dietary advice or a referral to a dietitian, will be arranged if the screening identified a concern
- Carer or family education sessions may be offered to help the people at home understand the patient's needs
- A review appointment, usually within three to six months, checks whether the plan is working and whether new problems have appeared
- Patients travelling from abroad for the assessment should confirm before leaving that they have a clear point of contact for questions once they return home
Cost & What Determines It
The cost of a CGA varies widely because it is not a single test but a multi-professional process whose scope is shaped by the patient's complexity. A straightforward two-hour assessment in a clinic costs far less than a multi-day inpatient evaluation that includes imaging, specialist consultations, and therapy sessions.
- Number of specialists involved: a geriatrician alone costs less than a full team including a neuropsychologist, physiotherapist, dietitian, and social worker
- Setting: an outpatient clinic appointment is less expensive than a day-hospital or inpatient admission
- Hospital class and country: fees at a university hospital or internationally accredited centre differ from those at a regional private clinic
- Tests ordered as part of the assessment: blood panels, cognitive test kits, EKG, urine analysis, imaging such as MRI or CT, and bone density scans each add to the total
- Number of sessions: some assessments are completed in one visit; others are spread over two or three appointments
- Complexity of the care plan: patients with many interacting conditions require more specialist time to review findings and produce a coordinated report
- Interpreter or translation services if the patient and the clinical team do not share a language
A hospital package for a CGA typically covers the geriatrician's consultation fee, standardised screening tools, and a written summary report. Additional charges often apply for specialist consultations outside geriatrics, laboratory tests, imaging, physiotherapy sessions, and any follow-up appointments. Ask the hospital for an itemised estimate so you know exactly what is and is not included.
BPJS Kesehatan and most Indonesian private health insurance policies do not cover medical care received outside Indonesia, so patients who travel abroad for a CGA usually pay out of pocket or through an international private insurance plan that specifically includes overseas treatment. Before travelling, request a written cost estimate from the hospital that lists each service separately. This protects against unexpected bills and gives you a clear basis for comparing options.
Frequently Asked Questions
Does a Comprehensive Geriatric Assessment hurt?
A Comprehensive Geriatric Assessment is not painful. It consists of conversations, questionnaires, and simple physical tasks such as walking a short distance or squeezing a grip device, so there are no needles or incisions involved.
How do I prepare for a Comprehensive Geriatric Assessment?
No fasting is required before a Comprehensive Geriatric Assessment. It helps to bring a list of all current medications, any recent test results, and, if possible, a family member or carer who can give the doctor a fuller picture of day-to-day functioning.
How long does a Comprehensive Geriatric Assessment take?
Most assessments take between one and three hours, sometimes spread across more than one visit. The team, which usually includes a geriatrician (a doctor specialising in the care of older adults), a nurse, and often a physiotherapist or social worker, needs enough time to cover physical health, mental sharpness, mood, medications, and home environment.
How much does a Comprehensive Geriatric Assessment cost?
The cost varies depending on the hospital class, how many specialists are involved in the assessment, and whether any additional tests such as blood work or cognitive screening tools are included. Requesting a written estimate from the hospital before booking is the most reliable way to understand the full cost.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
