Skip to main content
. 2023 Sep 27;10:1240082. doi: 10.3389/fmed.2023.1240082

Table 2.

ICEBERG tool (score range 1 to 30).

ICEBERG questionnaire
answers (score)
Score
Q1: Where does the patient live?
□ Living independently at home without support (0)
□ At home with support from family member and/or outside help (eg SPITEX) (2)
□ In a nursing home (3)
Q2: What is the patient's age?
□ 70-79 years (1)
□ ≥ 80 years (2)
Q3a: Falls (2+) in the last 12 months?
□ Yes (3)
□ No (0)
Q3b: Is a fall the reason for the current ER visit?
□ Yes (1)
□ No (0)
Q4a: Is there any sign for a cognitive disorder impacting everyday life activities?
□ Yes (3)
□ No (0)
Q4b: Has the patient felt down, depressed, or fatigued lately?
□ Yes (2)
□ No (0)
Q5: Can the patient count the months of the year backwards without ANY ERROR up to and including September?
□ Yes (0)
□ No (3)
Q6a: ER or emergency visit at GP in past month?
□ Yes (2)
□ No (0)
Q6b: Hospitalization in past 6 months?
□ Yes (2)
□ No (0)
Q7: How many drugs does the patient take regularly?
□ Between 0 and 3 drugs (0)
□ Between 4 and 7 drugs (1)
□ ≥ 8 drugs (2)
Q8a: Does the patient usually need any help with taking showers or bathing?
□ Yes (2)
□ No (0)
Q8b: Right now, can the patient transfer from a lying or sitting position to a standing position independently?
□ Yes (0)
□ No (2)
Q9a: Has the patient lost more than 3 kg weight without trying and/or do the clothes not fit anymore?
□ Yes (2)
□ No (0)
Q9b: Has the patient been eating poorly because of decreased appetite?
□ Yes (1)
□ No (0)