Early Comprehensive Geriatric Assessment in Acute Care: Evidence and Implementation

The growing prevalence of frailty among older adults presenting to acute care settings poses significant challenges for healthcare systems worldwide. Frail older patients are at increased risk of adverse outcomes, including delirium, functional decline, prolonged hospitalisation and mortality. Comprehensive Geriatric Assessment (CGA), a multidimensional and interdisciplinary approach to evaluating medical, functional, psychological, and social needs, has emerged to tackle some of these challenges. Despite its central role in evaluating frail patients, CGA is often only introduced after admission. Earlier recognition of frailty may support more individualised decision-making, better alignment of care with patient needs, and closer collaboration across multidisciplinary teams. This editorial argues that CGA should be initiated as early as possible within the acute care pathway, ideally beginning in emergency departments and acute medical units. This is considered alongside the challenges of implementing CGA, including workforce pressures, service configuration, and access to specialist expertise. As healthcare systems adapt to population ageing, earlier incorporation of CGA offers an opportunity to reshape the delivery of acute care for older adults.