The Age-Friendly Geriatric Assessment

As a significant portion of the US population ages, family physicians are seeing more adults older than 65. A recommended framework for geriatric assessment is the 4Ms: What Matters, Medication, Mentation, and Mobility. Clinicians should speak with patients and their families about what matters to them most in daily life and in their medical care. Clinicians should review medications to identify inappropriate drugs for discontinuation. They should also check for necessary medications that are missing or used incorrectly. For mentation, tools such as the Mini-Cog should be used for assessment when cognition is a concern. Abnormal results should prompt an evaluation for modifiable causes, mild cognitive impairment, and dementia. Mentation should also be addressed with screening for depression and factors that might predispose the patient to delirium. For mobility, clinicians should screen for fall risk with the Stopping Elderly Accidents, Deaths, and Injuries tool. Patients with positive results should be evaluated further and be instructed to begin exercise interventions, including physical therapy.