Comprehensive geriatric assessments

Medical visit

(at least twice a year)

• Medical history: Check medical problems, hospitalizations, allergies, adverse events, substance use, sexual habits
• Centralized medication history: Check prescription medications, over-the-counter and alternative remedies
• Physical examination: Vital signs, body mass index.
• Routine tests: Blood/urine tests; viral load and CD4/CD8 and T cells when required

Special approaches

(at least annually)

• Age-appropriate assessment of comorbidities (e.g., cancer, cardiovascular disease, bone)
• Evaluation of geriatric syndromes (falls, incontinence, sleep disorders, confusion, vision/hearing problems, sarcopenia)
• Update vaccines
• Screen for hepatitis C/B and other sexually transmitted infections (STIs)
• Physical function/frailty measurements (e.g., four-minute walk, time to rise from a chair, or grip strength)
• Nutritional assessment
• Neuropsychological and psychological evaluation (e.g., depressive symptoms, quality of life, neuropsychological test)
• Evaluation of social problems

Key actions

• Prevent chronic conditions or ensure early detection and control
• Check drug-drug interactions
• Stop unnecessary drugs (Stopp/Start criteria)
• Choose the most appropriate antiretroviral regimen according to the patient's conditions
• Reduce risk factors and encourage health behaviors. Counseling on diet and physical activity
• Intervention for sensory and physical problems
• Maintain muscle mass and bone density through exercise and nutrition
• Treat the underlying causes of decline in capacity
• Cognitive remediation if neurocognitive impairment
• Psychology/psychiatry if psychological problems (e.g., anxiety, depression)
• Social workers if social problems
• Capacity enhancing behaviors, strengthening personal skills, and building relationships