From Frailty to Function: Common Screening Tools of Comprehensive Geriatric Assessment in Primary Care

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Comprehensive Geriatric Assessment (CGA) is a multidimensional, interdisciplinary process that evaluates the medical, psychological, functional, and social health of older adults. In primary care, physicians move beyond disease-focused care toward a person-centered approach that supports independence, quality of life, and informed decision-making in geriatrics. The 5Ms of Geriatric Medicine—Mind, Mobility, Medications, Multi-complexity, and Matters Most—provide a practical framework for integrating core domains into everyday practice.

Mobility and physical function are central to maintaining independence and preventing decline. Within the 5M framework, this corresponds to Mobility, which involves assessing the ability to perform activities of daily living, ambulation, and fall risk. Beyond physical performance, it also emphasizes strategies to reduce fall-related injuries and preserve autonomy. Early identification of functional limitations guides timely rehabilitation and supportive interventions in primary care.

The Mind domain of the 5Ms highlights the importance of evaluating cognition, mood, and behavioral health. Memory loss, delirium, and depression are common but frequently underdiagnosed in older adults. Incorporating mental health and cognitive assessments into routine primary care visits ensures earlier recognition of impairment, supports caregiver involvement, and informs long-term planning. These considerations align directly with the core domains of cognition and psychological well-being.

CGA also encompasses frailty assessment, nutritional evaluation, and the review of medical comorbidities. These reflect the multi-complexity domain, where overlapping conditions, polypharmacy, and vulnerability to stressors complicate care. The Medications domain draws attention to the risks of inappropriate prescribing, drug interactions, and the need for regular medication review. Within the broader field of geriatrics, these assessments help primary care physicians reduce preventable complications and promote safer prescribing practices.

Social factors, including living arrangements, financial resources, and caregiver support, are integral to the CGA. These considerations align with the Matters Most principle, which emphasizes respecting patient goals, values, and preferences in the care plan. Addressing social determinants of health allows physicians to provide care that is not only clinically appropriate but also meaningful to the individual and sustainable within their support network.

At the end of the learning activity, physicians will be familiarized with the core domains of comprehensive geriatric assessment and the 5Ms of Geriatric Medicine as a guiding framework. By applying these principles in everyday geriatrics practice, clinicians can more effectively identify vulnerabilities, tailor interventions, and prioritize what matters most to each older adult.