From the Guidelines
Geriatric assessments are crucial in older adults with cancer to identify vulnerabilities and predict adverse outcomes from chemotherapy.
Relevant Assessments
The following assessments are relevant in geriatric care:
- Functional status: including activities of daily living (ADLs) and instrumental activities of daily living (IADLs) 1
- Physical performance and falls: including measures of mobility and falls in the past 6 months 1
- Comorbidity: including the presence of chronic medical conditions such as diabetes, heart disease, and liver or kidney disease 1
- Cognition: including the use of tools such as the Mini-Cog to assess cognitive impairment 1
- Depression: including the use of tools such as the Geriatric Depression Scale (GDS) to assess depressive symptoms 1
- Social activity/support: including the assessment of social support and the presence of a healthcare proxy 1
- Nutritional status: including the assessment of weight loss and malnutrition 1
- Risk of chemotherapy toxicity: including the use of tools such as the CARG toxicity tool to predict the risk of chemotherapy toxicity 1
Recommendations
These assessments can help identify vulnerabilities and predict adverse outcomes from chemotherapy, and can inform treatment decisions and care planning for older adults with cancer 1. A comprehensive geriatric assessment can be useful in addressing the multifactorial nature of the needs of older adults with cancer 1.
From the Research
Geriatric Assessment Overview
The geriatric assessment is a comprehensive, multifaceted, and interdisciplinary evaluation of medical, socioeconomic, environmental, and functional concerns unique to older adults 2. It can be focused or broadened according to the needs of the patient and the concerns of clinical providers. This assessment is a basic requirement and a key quality parameter in geriatric care 3.
Key Components of Geriatric Assessment
The geriatric assessment includes the evaluation of:
- Medical concerns, such as nutrition, vision, hearing, fecal and urinary continence, and balance 4
- Cognitive and mental health, including the assessment of cognitive impairment and depression 5
- Socioenvironmental circumstances, such as social support network and economic status 5, 6
- Functional ability, including the assessment of activities of daily living and risk of falls 4, 6
Tools and Methods Used in Geriatric Assessment
Specific tools and methods are used to assess older adult patients across a variety of settings, including:
- Validated, brief screening tests that measure the patient's performance of daily living activities, cognition, nutritional status, and risk of falls 6
- Self-administered questionnaires and brief performance-based measures of physical functioning 6
- Digital applications of basic geriatric assessment data, which are becoming increasingly important for high-quality follow-up care of geriatric patients 3
Benefits of Geriatric Assessment
The geriatric assessment aids in: