Assessment of sleep in older people within comprehensive geriatric assessments: a scoping review.

backgroundSleep problems are highly prevalent in the older population, with associated physical and mental health effects. They should be identified within a Comprehensive Geriatric Assessment (CGA), a multidimensional evaluation of an older person's health. However, the extent to which sleep is routinely assessed within CGAs and the methods used, remain unclear.

objectivesThe aim of the review was to describe the assessment tools, practitioners involved and the settings in which sleep assessments were conducted within CGAs.

methodsA systematic search was conducted across five electronic databases and grey literature sources between January 1993 and June 2025. Relevant data including healthcare setting, practitioners involved, sleep assessment tool(s) and questions used were extracted.

resultsOf 1842 identified references, 136 were included for review. Across 54.4% sources, 28 different assessment tools were identified, with the Pittsburgh Sleep Quality Index being most used (21.3%). General screening questions were utilised in 42.6% sources, most often (81.6%), in place of an assessment tool. The most frequent question related to difficulty falling asleep. Sleep assessments were commonly conducted by nurse/nurse practitioners and geriatricians. They were predominantly performed in secondary care (55.9%), particularly within outpatient geriatric clinics.

conclusionsSleep assessment within CGAs varies globally. Incorporating screening questions regarding sleep problems could prompt a more holistic assessment of health and wellbeing in the older person, which could feasibly be performed within a CGA by any practitioner. Guidance defining the standards for assessing sleep within a CGA is needed.