Signs Your Loved One Needs a Geriatric Assessment

Frequent Falls or Difficulty with Balance and Mobility

Falls are one of the most serious health concerns in older age. In the UK, falls are the leading cause of injury-related death in people aged 75 and over, and around one in three adults over 65 falls at least once per year [5]. A single fall should not be dismissed as bad luck. Falls are often the visible result of underlying problems, including muscle weakness, impaired gait, visual decline, medication interactions, postural hypotension or early cognitive changes [6].

A geriatric assessment includes a formal falls risk evaluation, identifying contributing factors and enabling targeted interventions such as strength and balance programmes, medication reviews or home hazard assessments that have been shown to reduce fall rates [7].

Memory Problems, Confusion or Cognitive Decline

Memory complaints are among the most common reasons families seek a geriatric opinion. While some degree of cognitive slowing is a normal part of ageing, persistent or worsening difficulties with memory, language, planning, navigation or decision-making are not [8]. Conditions such as mild cognitive impairment (MCI) and the various forms of dementia – including Alzheimer’s disease, vascular dementia and Lewy body dementia – require careful diagnostic evaluation to distinguish between them and from other causes of confusion such as urinary tract infections, thyroid dysfunction, vitamin deficiencies or medication effects [9].

Early diagnosis matters. Research published in The Lancet found that timely identification of dementia enables earlier access to treatment, support planning, and participation in decision-making while the person still has the capacity to do so [10]. A CGA incorporates validated cognitive screening tools, alongside collateral history and relevant investigations, to provide a thorough picture.

Increasing Difficulty Managing Daily Activities

When an older person begins to struggle with activities they previously managed independently – preparing meals, managing finances, taking medications correctly, driving safely or maintaining personal hygiene – this represents a meaningful functional decline that warrants assessment [11]. Geriatricians distinguish between activities of daily living (ADLs), such as dressing and bathing, and instrumental activities of daily living (IADLs), such as shopping, cooking and managing appointments. Decline in IADLs often precedes more obvious functional impairment and can be an early indicator of cognitive or physical changes [12]. Identifying these changes early allows practical support to be put in place before further decline occurs.

Multiple Long-Term Conditions and Polypharmacy

Older adults frequently live with several co-existing health conditions simultaneously – a situation known as multimorbidity. Managing these conditions often results in complex medication regimens. Polypharmacy, typically defined as the regular use of five or more medications, is associated with increased risk of adverse drug reactions, falls, confusion, hospitalisation and reduced quality of life [13].

A geriatric assessment includes a structured medication review to identify drugs that may no longer be appropriate, maybe interacting with one another, or that are contributing to symptoms. Studies have demonstrated that geriatrician-led medication reviews reduce polypharmacy-related harms and improve patient-reported outcomes [14].

Low Mood, Anxiety or Social Withdrawal

Depression affects approximately 22% of men and 28% of women aged 65 and over in the UK, yet it remains significantly underdiagnosed and undertreated in this age group [15].  Older adults are less likely to present with sadness as a chief complaint, and may instead report fatigue, unexplained physical symptoms, loss of motivation or withdrawal from activities and relationships.16

Anxiety disorders are similarly common and can contribute to avoidance behaviours that compound physical deconditioning and social isolation. A comprehensive geriatric assessment considers emotional well-being alongside physical health and may include validated mental health screening tools, helping ensure that depression and anxiety are not overlooked.

Unplanned Hospital Admissions or Slow Recovery

Repeated unplanned hospital admissions – or difficulty recovering to previous levels of function following illness, surgery or hospitalisation – can be a sign that an older person is living with frailty [17]. Frailty is a recognised clinical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors [18]. It is not simply a consequence of age, and it is not inevitable. 

Frailty can be identified, measured and meaningfully modified through targeted interventions. Geriatric assessment is the gold standard approach to frailty identification, guiding personalised care plans which may include nutritional support, physical rehabilitation, social care coordination and advanced care planning [19].

Caregiver Concern or a Sense That Something Has Changed

Sometimes the most important signal is an informal one. Family members and carers who know their loved ones often notice subtle changes before formal assessments detect anything measurable – a change in personality, increasing forgetfulness, a loss of spark, a growing reluctance to leave the house.

These observations are clinically valuable. Information from those who know the patient well forms an important part of any comprehensive geriatric evaluation, and a caregiver’s instinct that something is not quite right is a legitimate and important reason to seek a professional opinion.