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. 2012 Aug 7;104(15):1134–1164. doi: 10.1093/jnci/djs285

Table 2.

Overview of the results of the feasibility of the assessments as reported in the article*

First
 author, year
 (reference) Sample size Location and
 timing of geriatric
 assessment Time
 needed to
 complete the
 assessment Assessment
 completed by Results of the geriatric assessment Other
 information
 about
 feasibility
Geriatric assessment studied in a prospective observational study design
Aaldriks, 
    2011 (18) 202 In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR 10% were frail by MMSE score, 32% by MNA score, 37% by GFI score, and 15% by IQCODE score NR
Aparicio, 
    2011 (19) 21 During admission or stay at inpatient ward, before chemotherapy NR Gastroenterologist MGA (CGA): 43% (38%) had mental status abnormality, 43% (43%) depression, 48% (33%) dependence, 67% (71%) nutrition problems, 62% (52%) comorbidities, 38% (48%) polypharmacy, 33% (33%) living situation (including caregiver support and fall hazards in the home), and 65% (50%) low hemoglobin levels or creatinin clearance NR
Arnoldi, 
    2007 (20) 153 Outpatients, timing NR NR NR 109 were not frail, 30 borderline, and 14 frail. The functional status in all three groups was not severely compromised NR
Audisio, 
    2008 (21) 460 During admission, before surgery PACE was administered in a 20-min interview Trial nurse or student 
physician Of the 90% classified as having a PS score of 0 or 1, 11% had ADL disability, 11% MMSE score <24, 23% GDS score >4, 28% moderate or severe BFI score and 35% IADL dependence, and 61% had an abnormal outcome on at least one other PACE component NR
Bailey, 
    2003 (22),
    2004 (23)§ 337 Location NR, before treatment and after treatment NR NR NR NR
Bamias, 
    2007 (24) 34 In hospital, not specified if in- or outpatient setting, before chemotherapy, after treatment NR NR 68% had PS score >2, 65% had comorbidities, median VES-13 score was 6. Two patients were classified as group 1 (PS score 0), 24 in group 2 (PS score 1), and 6 in group 3 (PS score 2 and 3) NR
Bylow, 
    2008 (25)|| 50 In hospital, after at least 3 mo of ADT NR NR 24% and 42% had impairments in ADL and IADL, respectively; 24% had abnormal SPMSQ score, 14% had fatigue, and 8% were nutritionally deficient. 56% had abnormal SPPB findings and 22% had fallen in the previous 3 mo 50/58 completed assess-
ment
Castagneto, 
    2004 (26) 25 In hospital, not specified if in- or outpatient setting, before chemotherapy and after three courses of chemotherapy and at the end of treatment NR NR 2 patients had ADL disability, 6 patients IADL disability, 4 patients scored positive on the GDS. 11 patients were fully independent according to CGA parameters Two patients refused CGA evaluation
Chaibi, 
    2011 (27) 161 In hospital, not specified if in- or outpatient setting, before chemotherapy, after tumor board recommendation NR NR 47% had at least one comorbidity, 32% had ADL disability and 67% had IADL disability, 40% were at risk for malnutrition, and 25% were malnourished, 76% had geriatric interventions, 28% had higher dose intensity after CGA, and adherence to planned dose intensity was possible for 71% of patients NR
Clough-Gorr,
    2010 (73) 660 Location NR, after surgery 45min (average) Physicians 42% had CCI score ≥1, 85% had good self-rated health, 21% were obese, 37% had ≥1 physical limitation, 69% had good mental health, 51% had good level of social support, 43% had deficits in ≥3 domains NR
Extermann,
    2004 (74) 15 Before chemotherapy, before radiation, after surgery at initial Senior Adult Oncology Program outpatient visit NR Multidisciplinary team Median number of comorbidities was 5; 10 patients were at pharmacological risk, 5 were at psychosocial risk, and 8 were at nutritional risk. Patients had an average of six problems at baseline and three new problems during follow-up 2/15 refused 
assessment
Freyer, 
    2004 (28) 26 In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR 26 patients were included, MGA done for 19 patients (reasons why the 7 other patients were not assessed, NR) NR
Freyer, 
    2005 (29) 83 In hospital, not specified if in- or outpatient setting, before chemotherapy NR Study author 73.5% completely independent at home, 40% on ≥4 drugs per day, mean MMSE score 27 NR
Fukuse, 
    2005 (100) 120 In hospital, not specified if in- or outpatient setting, before surgery NR Study authors 65% had one or more comorbidities, 12.5% had a BMI <18.5 and 14.2% had a BMI >25kg/m2 (1.8% had PS score <2 and 89.7 had no ADL disability. 91.4% had a normal MMSE score NR
Hurria, 
    2006 (30) 20 (19 were evaluable) In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR Median ADL score = 18 (maximum 18), median IADL score = 20 (maximum 21), median KPS score = 80, median CCI score = 3, and median GDS score = 2 NR
Hurria, 
    2006 (32) 50 (49 were evaluable) In hospital, not specified if in- or outpatient setting, before chemotherapy, at start and 6 mo after completion of treatment NR Investigator, who was also physician, or other member of study team Pretreatment median scores: ADL = 17; IADL = 21; GDS = 2; CCI = 3; FACT-B: physical wellbeing = 26, social wellbeing = 26, emotional wellbeing = 20, functional wellbeing = 22, breast scale = 27, and total = 117. Mean BMI = 28kg/m2 NR
Hurria, 
    2006 (31) 31 (28 
participated 
in neuro
psycholo-
gical tests) Before chemotherapy, at start, and 6 mo after completion of treatment NR NR Of 28 patients, 3 scored ≥2 SD below the published norms on two or more neuropsychological tests at baseline and 6 mo after chemotherapy; 8 patients scored ≥2 SD below published norms for two or more neuropsychological tests NR
Kothari, 
    2011 (33) 60 Outpatient preoperative clinic visit, before surgery NR Patient completed questionnaire One patient died within 30 d of surgery. Major complications were observed in 8 patients and 6 patients were discharged to a location other than home NR
Kristjansson,
    2010
    (71,75)# 182 Location in hospital, not mentioned if in- or outpatient, before surgery 20–80 min Investigator, who was also a physician 21 patients were classified as fit, 81 as intermediate, and 76 as frail according to a modified Balducci classification; 28 patients had ADL dependency, 41 had severe comorbidity, 11 took ≥8 medications/d, 16 had malnutrition, 12 had cognitive impairment, and 18 had depression. 3 died after surgery, 107 experienced complications, 83% of which were severe Patients with some degree of cognitive impairment were interviewed in presence of their caregiver, data with regard to functional status was confirmed by nursing home staff or hospital staff
Marenco
    2008 (34) 571 Initial outpatient visit, before treatment NR NR 18% had BMI<21kg/m2, mean CIRS score = 17, mean KPS score = 68; 28% had ADL disability, mean IADL score = 9, mean SPMSQ score = 1 NR
Marinello,
    2008 (35) 110 In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR 50% had CIRS score >6; 55% had SPMSQ score of 0; 78% did not live alone; most had good ADL, IADL, and KPS scores (no results reported); 66% experienced some treatment failure, 13% died, 40% had grade 3 or 4 toxicity, and 17% had treatment interrupted NR
Massa, 
    2006 (36) 10 In hospital, not specified if in- or outpatient setting, at baseline and after 4, 8, and 12wk of treatment The authors indicated that assess-ment was “brief” NR At baseline, 4 patients had a MMSE score <23 NR
Massa (76) 75 In hospital, not specified if in- or outpatient setting, before treatment NR NR 26 patients were classified as fit, 23 as intermediate, and 26 as frail (unclear how defined) NR
Presant, 
    2005 (37) 26 In hospital, not specified if in- or outpatient setting, before chemotherapy 10–15min Performed by medical assistant after only 15min of training; however, some scales completed incorrectly and not evaluable (rates of evaluable responses: pain 83%, energy 96%, QOL 91%, longer ADL and IADL forms both 52% Mean scores: ADL 22, IADL 18, pain 1.4, energy 2.1, QOL 2.3 Study authors reported that patients found the question-
naire easy to complete and useful in communi-
cating symptoms 
to physicians; easy to administer 
and short 
time for completion; completed by patient or patient plus family with 
no additional help
Puts, 
    2010 (94),
    2011
    (95)** 112 During visit to outpatient clinic or during admission, before treatment Mean 45min 
(IQR = 
40–55
min) Investigators 88% had ≥1 frailty marker, 54% had mobility impairment, 45% were physically inactive,40% had poor nutritional status, 28% had fatigue, 24% had cognitive impairment, 23% had mood disturbance, 21% had low grip strength, 35% had IADL disability, and 11% had ADL disability 92% did not feel interview was too long, 78% had complete assess-
ments
Rao, 
    2005 (38) 99 During admission or stay at inpatient ward NR NR 27 patients received usual in- or outpatient care, 19 received geriatric inpatient and usual outpatient care, 28 received usual inpatient and geriatric outpatient care, and 25 received geriatric in- and outpatient care NR
Tredan, 
    2007 (39) 83 (Trial I), 
75 (Trial II) In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR Presence of clinical symptoms of depression, abnormal MMSE scores, and number of medications taken daily were more frequent in CC group than in CP group; at least 1 IADL dependency was reported among 38 patients in CP group, none in CC group, median HADS score = 12 in CP group NR
Tucci, 
    2009 (40) 84 In hospital, not specified if in- or outpatient setting, before surgery, before radiation 15 min Physician and registered nurse 50% were classified as fit and 50% as unfit (Balducci classification) NR
Wedding,
    2007
    (41)†† 427 During admission before chemotherapy NR NR In 427 patients, 35% had an ADL score <100% (indicating disability), 28.4% had an IADL score <8 (indicating disability), and 30% had ≥1 comorbidities NR
Geriatric assessment studied in a cross-sectional study design
Bearz, 
    2007 (42) 22 NR NR NR 5 patients were scored as unfit, 8 patients were scored as frail, and 9 were scored as fit using the investigators’ own classification scheme (frail = patients aged ≥80 y, or patients aged ≥70 y with ≥3 grade 3 comorbidities, or patients with 1 grade 4 comorbidity and an ADL disability in ≥1 items or a geriatric syndrome NR
Bylow, 
    2011 (43) 134 In hospital, not specified if in- or outpatient setting, case patients received at least 6 mo of ADT NR Data were from patients and medical chart Using the modified Fried frailty criteria, 8.7% of patients were frail, 56.6% were prefrail vs 2.9% and 48.8%, respectively, in the control group (men with a history of prostate cancer after surgery or radiation, not on ADT and with no evidence of disease using PSA). 32% of patients vs 24% of control subjects had SPPB score <10. 14.3% of patients had reported a fall in the previous 6 mo vs 2.8% of control subjects NR
Di Mauro,
    2000 (44) 108 In hospital, not specified if in- or outpatient setting, timing NR NR NR Average Satariano and Ragland comorbidity score was 2.5 in the cancer patients, 33% had depressive symptoms, 21% had an MMSE score <24 NR
Dujon, 
    2006 (45) 41 In hospital, not specified if in- or outpatient setting, before treatment 30min (average) Two investigators, who were also physicians 50% had ADL disability and 95% had IADL disability, 29% had a MMSE score <24, 17% had a PINI score >20, average CCI score was 2.7 NR
Extermann,
    1998 (46) 203 Initial visit to Senior Adult Oncology Program NR Multidisciplinary team 79% had no ADL disability, 44% had no IADL disability, 31% had ECOG PS score of 0, 64% had a CCI score of 0, and 6% had a score of 0 on CIRS-G NR
Girones, 
    2010 (47) 91 Follow-up visit in outpatient oncology clinic 30–40 min Investigator, who was also a physician 4% had no ADL disability, 37% had no IADL disability, 10% had PS score of 2, median CCI score was 2, 28% had a geriatric syndrome, 37% were defined as frail according to the Balducci classification NR
Girre, 
    2008 (48) 105 In geriatric oncology clinic, timing NR 10 min Investigator, who was also a physician 58% were independent in ADL, 46% were independent in IADL, 20% had good nutritional status, 20% had impaired mobility, 53% had depressive symptoms, 33% had ≥2 comorbid conditions, 74% took ≥3 drugs NR
Hurria, 
    2005
    (88) 43 agreed to participate 
(40 partici-
pated) The assessment was completed in physician’s office during outpatient visit Mean time to complete 
= 27min (SD = 10min, range = 
8–45min) Patient and interviewer together 63% had the maximum IADL score, 28% reported one or more falls, 8% reported clinically significant anxiety or depression, 45% had limitations in social activities, 5% had low BMI, and 48% reported weight loss 78% did not need assistance to complete, 83% said the assessment was easy to understand, 90% were satisfied with the length of the question-
naire, 100% stated no items were upsetting
Hurria, 
    2007
    (89)‡‡ 250 (245 completed survey) The patients were mailed the questionnaire prior to appointment or received it at their appointment Mean time to complete 
= 15min (SD = 10min, range = 
2–60min). 
ESL patients 
took most time Patient Mean ADL score 12 (maximum 14), 49% had IADL disability, 74% had KPS score >70%, 21% had a fall, 94% had ≥1 comorbidity, 21% rated their distress score >5, 20% were underweight, and 26% had lost weight 78% completed without assistance; of those who needed assistance, 19% got it from friends or family. 94% said that the question-
naire was easy to under-
stand and 91% were satisfied with its length. 89% had complete question-
naires
Hurria, 
    2009
    (90)‡‡ 245 Patients were mailed the questionnaire prior to appointment or received it at their appointment Mean time to complete 
= 15min (SD = 10min, range = 
2–60min). 
ESL patients 
took most time Patient 41% reported a distress score of ≥4
Ingram, 
    2002 (85) 154 Questionnaire was sent 2wk prior to scheduled appointments for initial consultations and follow-up appointments NR Patient Mean number of medications was 6, mean number of comorbidities was 5, 69% had ADL disability, 58% had IADL disability, mean pain score was 4.2 (range = 0–10), 76% rated their health as fair or poor, 32% and 26% scored positive for depression and anxiety, respectively Response rate to mail question-
naire was 64%
Kellen, 
    2010 (49) 113 NR It took 15min to complete the three screening instruments, and 30min for the CGA Trained medical staff GFI classified 31% as vulnerable, the VES-13 classified 49% as vulnerable (classification by aCGA NR) NR
Kim, 
    2011 (50) 65 In hospital, not specified if in- or outpatient setting, before chemotherapy NR Trained geriatric nurse 25% had CCI score ≥2, 23% had ADL disability, 14% had IADL disability, 51% had mild cognitive impairment, 40% had depression. Frail patients had statistically significantly poorer PS and worse global health and QOL scores compared with nonfrail patients NR
Luciani, 
    2010 (51) 419 In hospital, not specified if in- or outpatient setting, before treatment NR NR 53% were vulnerable according to the VES-13, 30% had ADL disability, and 25% had IADL disability NR
Lynch, 
    2007 (52) 85 In hospital, not specified if in- or outpatient setting, timing NR NR Social work intern Most frequently reported need was emotional support, followed by caregiver support and transportation issues NR
Mantovani,
    2004 (53) 84 older cancer patients, 59 adult cancer patients In hospital, not specified if in- or outpatient setting, timing NR NR NR 15% of elderly patients had severe functional impairment, 46% had IADL disability, 16% had depression according to BDI scores, 41% had MMSE score <24, 29% had MNA score <12 NR
Mohile, 
    2007 (78)|| 58 agreed to participate and 50 had data In hospital, not specified if in- or outpatient setting, timing NR NR NR 50% were impaired according to the 
VES-13 score (60% according to CGA) 50/58 had complete assessment
Mohile, 
    2009 (54) 12 480 NR NR Investigator used data from databases Persons with a history of cancer had a higher prevalence of ADL and IADL disabilities and geriatric syndromes, low self-rated health, a VES-13 score >3, and frailty according to the Balducci classification compared with persons without cancer NR
Molina-
    Garrido, 
    2011 (55) 41 In hospital, not specified if in- or outpatient setting, before chemotherapy NR Investigator who was also physician 37% had ADL disability, 46% had IADL disability, 2% were at social risk, 46% had no comorbidity, 42% had 1 comorbidity, 10% had 2 comorbidities, and 2% had 3 comorbidities, 20% had a cognitive deficit using the Pfeiffer scale, 34% were at risk of malnutrition, and 39% took >4 drugs NR
Molina-
    Garrido, 
    2011 (56) 99 After oncology service referral, during outpatient visit, timing NR Mean time 
needed to complete 
CGA = 
12.87min (range = 
9.5–20min) Investigator who was also a physician 87.5% were at risk of frailty, 65.3% were ADL dependent, 75% were IADL dependent, 29.3% had some degree of cognitive impairment, 46.7% were at risk of malnutrition Patients’ opinions regarding length of survey: very long (36.4%), short (0%), suitable (63.6%); difficulty: difficult (30.3%), acceptable (69.7%), easy (0%)
Monfardini,
    1996 (57) 30 During admission or stay at inpatient ward, during routine visits Mean = 27.4 min (range = 
20–45min) Two physicians Patients were moderately disabled, had several depressive symptoms and good cognitive functioning. No actual numbers reported NR
Overcash,
    2007 (58) 165 Patients seen at Senior Adult Oncology Program, not specified if in- or outpatient setting, timing NR 30 min Interview with trained data collectors 37 patients had experienced a fall NR
Overcash
    2008 (77) 352 Patients seen at Senior Adult Oncology Program outpatient clinic 30 min Interview with trained data collectors The population was divided into three groups: no treatment, treatment, and geriatric. Mean ADL scores were 17.5, 17.6, and 16.7, respectively; mean GDS scores were 2.1, 2.9, and 2.4, respectively; mean MMSE scores were 28.4, 27.9, and 25.0, respectively; and percentages with a fall were 25%, 33%, and 42%, respectively. NR
Pignata, 
    2008 (59) 26 In hospital, not specified if in- or outpatient setting, before chemotherapy NR NR 65.4% had no ADL disability, 69.2% had at least 1 IADL disability, and most patients had at least 1 comorbidity, 50% had 2 or more comorbidities NR
Pope, 
    2006
    (60) 460 During admission, before surgery PACE was administered in a 20-min interview Trial nurse or student physician 33.3% had 1 or more comorbidities. 85.0% and 59.8% were independent in ADL and IADL, respectively; 87.8% had normal MMSE score, 73.3% were not depressed, 69% had no or mild fatigue, and 91% had PS score <2
Repetto, 
    2002 (61) 363 During admission or stay at inpatient ward 20min (average) Data used in assessment was obtained from medical chart and patient questionnaire 74% had PS score <2, 86% were independent in ADL and 52% were independent in IADL. 41% had 1 or more comorbidities, 27% had abnormal MMSE scores, and 40% had 1 or more depressive symptoms NR
Retornaz,
    2008 (93) 50 Patients were assessed for the study when they were admitted or during initial or routine outpatient follow-up visit NR Investigator who was also a physician 12% were completely independent, 42% had frailty markers but no disability, 30% had an IADL disability but no ADL disability, and 16% had an ADL disability. The most prevalent frailty markers were nutrition (62%), mobility (58%), physical inactivity (42%), cognition (42%), grip strength (26%), mood (22%), and fatigue (12%) NR
Roche, 
    1997 (62) 50 After initial visit to geriatric oncology outpatient clinic NR Patients were seen in the geriatric oncology clinic, NR who conducted the assessment 74% had no ADL disability and 56% had disability in IADL functioning. 27% showed cognitive deficits, 24% were considered to be depressed. The study participants who were not receiving active cancer treatment were more functionally impaired in ADL (P = .006) and IADL (P = .004) compared with those who were receiving active cancer treatment NR
Serraino, 
    2001 (63) 303 During admission or stay at inpatient ward NR Interview with geriatrician 17% had ADL disability, 59% had IADL disability, and 13% had limitations in taking medications. 54% of patients aged <80 y had PS score of 2–4 compared with 22% of patients aged 65–69 y (P < .001); presence of comorbidity was the same for these two age groups; frequency of IADL limitations more pronounced in oldest group aged ≥80 y of elderly patients compared with those aged 
65–69 y (P = .03) NR
Siegel, 
    2006 (64) 25 At outpatient clinic visit, timing NR Assessment (three performance tests) took <5min NR Most had ECOG PS score of 1, the variance was highest for grip strength, less for TUG, and least for the Tinetti test. Among patients with ECOG PS score of 1, these measures were able to further identify subgroups with different functional status NR
Stauder, 
    2010 (65) 78 During admission or stay at inpatient ward NR NR Median values: KPS score = 90, ADL score = 100, WHO PS score = 1, VES-13 score = 2, IADL score = 7, GSD score = 7.5, CCI score =1, CIRS-G score = 5.5, MMSE score = 27, BMI = 24.7kg/m2 NR
To, 2010
    (66) 200 Location NA, before initial medical oncology visit The first 100 patients needed 17min (average) to complete Patients completed a questionnaire that was mailed prior to the first appointment 45% had ADL disability and 41% had IADL disability, 35% had KPS score <70, 22% had a fall, 34% had weight loss >5% in the last 6 mo, 26% had limited social support, 39% received some support service, 22% had memory problems; 60% were classified as vulnerable, 28% as fit, and 13% as frail using own classification scheme (4–5 factors of assessment of concern = frail, 1–3 factors of concern = vulnerable, and 0 factors = fit). Those who were frail had worse functional status 84% reported complete satisfaction with length, style, and clarity. Patients or proxies were expected to complete questionnaire before appointment, but in some cases, a geriatric oncology nurse assisted
Venturino,
    2000 (67) 45 In hospital, not specified if in- or outpatient setting, timing NR NR NR Descriptive (% of patients): 11.2% had PS score ≥2, 20% was ADL dependent (impaired in at least 1 item), and 51.2 % was IADL dependent (impaired in at least 1 item). Of all patients, 46.7% screened GDS positive and 24.5% scored impaired on the MMS. Of all patients, 64.4% had arthrosis or arthritis, 44.4% had hypertension, 35.5% had vascular diseases, 31.1% had digestive disease, and 28.8% had CNS diseases (excluding stroke) NR
Wedding,
    2007
    (68)†† 477 Admitted to hospital, before chemotherapy NR NR In group A (elderly cancer patients), 36.8% needed help with IADL, 27.5% had a KPS score of 10%–70%, and 37% had 2 or more comorbidities. In group B (younger cancer patients), 18.7% needed help with IADL, 18.5% had a KPS score of 10%–70%, and 16% had 2 or more comorbidities. In group C (elderly noncancer patients), 24.2% needed help with IADL, 14% had a KPS score of 10%–70%, and 42 % had two or more comorbidities NR
Wedding,
    2007
    (99) 200 During routine oncology visit in outpatient setting Median duration of assessment 20min (range 
= 9–47min) Two physicians 50% had maximum ADL score, 54% had maximum IADL score, 43% had poor nutritional status or were at risk, 8% had cognitive impairment using MMSE score, 23% had increased risk of falls, 16% had ≥2 comorbidities. According to the Balducci classification, 25% were fit, 25.5% were vulnerable, and 49.5% were frail. Physicians identified 64% as fit, 32.4% as vulnerable, and 3.2% as frail. The CGA identified a mean of 1.3 problems in those identified as fit, 2.3 problems in those identified as vulnerable, and 4.2 problems in those identified as frail NR
Geriatric assessment studied in retrospective studies or chart reviews
Barthelemy,
    2011 (98) 192 (93 underwent 
geriatric assess-
ment) After hospital referral, not clear when and where the assessment took place NR NR 36 patients were fit, 47 were vulnerable, and 10 were frail using the Balducci classification. Median age of fit patients was 75.4 y, vulnerable patients 80.3 y, and frail patients 87.4 y NR
Basso, 
    2008 (79) 117 Admitted to medical oncology ward, before chemotherapy NR Multidisciplinary team 33.3% were fit, 32.5% were vulnerable, and 34.2% were frail using the Balducci classification. 39.3% received an “elderly friendly” regimen, the others received a standard regimen NR
Cudennec,
    2007 (72) 124 During admission or stay at inpatient ward, outpatient (not specified) Within 1 h NR Assessment was done in 82% of inpatients and 18% of outpatients presenting with gastrointestinal cancer. Average MMSE score was 23, 43% had probable depression, 40% had abnormal TUG score, 26% required a more thorough geriatric evaluation NR
Cudennec,
    2010 (84) 57 In hospital, not specified if in- or outpatient setting, before treatment decision The Simplified Geriatric Evaluation took 1h (average) NR All patients lived at home and took on average 6.8 drugs per day, 51% had MMSE score <26, 47% were suspected of having depression, 68% were at risk for falls, and 44% had loss of autonomy. 5% were classified as fit, 68% were intermediate, and 42% were vulnerable. All patients in the fit group were considered able to receive optimal treatment, compared with none in vulnerable group and some in the intermediate group NR
Flood, 
    2006 (92) 119 During admission to hospital NR Data from medical chart Of the 11 patients who had a positive GDS score, 7 had depression documented by physician team. 42 patients had an abnormal Clock Construction Test score and 25 patients had an abnormal Short Blessed Test score, but 36% of all patients had cognitive impairment according to treating team. Of all patients, 45% had ADL disability and 74% had IADL disability, 87% were able to return home, 35% had a history of weight loss NR
Fratino, 
    1999 (69) 363 During admission or stay at inpatient ward NR Patient filled out questionnaire and data from chart 26% had a poor PS score, 41% had comorbid conditions, 14% had ADL limitations, 48% had IADL limitations, 27% had poor MMSE scores, and 40% had depressive symptoms NR
Garman, 
    2004 (86) 102 admitted, 36 with cancer During admission or stay at inpatient ward NR Data from medical chart The mean number of comorbid conditions was 4.6, the mean number of symptoms was 2.5, and the mean KPS score was 55%. 53% had cognitive impairment NR
Koroukian,
    2006
    (91)§§ 2552 Location NR, during admission to Medicare Home Health Care NR Investigator used databases The proportions of patients with no comorbidity, disability, or geriatric syndromes were 26.4% (breast cancer), 12% (prostate cancer), and 14% (colorectal cancer). The proportions with comorbidity, disability, and geriatric syndromes were 11.7%, 24.7%, and 15.7%, respectively. With increasing age, the proportion of persons with no comorbidity, disability, or geriatric syndromes declined NR
Koroukian,
    2010
    (80)§§ 1009 Location NR, during admission to Medicare Home Health Care NR Investigator used databases 15% had 1 functional limitation, 22% had ≥2 functional limitations, 31% had 1 geriatric syndrome, 17% had ≥2 geriatric syndromes, 29% had 1 comorbidity, 22% had ≥2 comorbidities NR
Overcash,
    2005 (81),
    2006 (83)
    || || 352 In hospital, not specified if in- or outpatient setting, at initial visit to Senior Adult Oncology Program NR Chart review 500 charts were reviewed, no other information presented NR
Retornaz,
    2008 (82) 183 Admitted to hospital, before chemotherapy NR Chart review 67% admitted for acute medical problems and 33% admitted for diagnosis. More than 10% had geriatric syndromes, 60% took ≥3 medications, 53% had ADL disability and 64% had IADL disability, 67% had mobility impairments and malnutrition, 50% had depressive symptoms NR
Rollot-Trad,
    2008 (97) 54 In hospital, not specified if in- or outpatient setting, timing NR NR Chart review 74% had a CCI score of 0–3, 22% had a CCI score of 4–5, and 2% had a CCI score >5; 39% took 4 or more medications, 69% had social support, 98% lived at home, 24% were depressed; 61% were independent in ADL, 63% were independent in IADL, 27% had an MMSE score <24 NR
Sorio, 
    2006 (70) 17 In hospital, not specified if in- or outpatient setting, timing NR NR NR 11 patients were considered not to have an increased risk for adverse outcomes (also called geriatric risk in this study) and 6 patients had a geriatric risk score of 1, which was defined as: PS 2, taking more than two medical treatments, and/or ADL or IADL disability NR
Terret, 
    2004 (87) 60 Patients seen in geriatric oncology program (not specified if in- or outpatient setting), before treatment Mini-CGA lasted 90–120 min NR 66% had an ADL disability and 87% had an IADL disability; all patients had clinically significant comorbidity; 50% were at risk for falls; 67 had a GDS score <15, 45% had cognitive disorders, and 65% were malnourished or at risk of malnutrition NR
Yonnet, 
    2008 (96) 363 In hospital, not specified if in- or outpatient setting, timing NR NR Chart review According to the Standardized Geriatric Evaluation (Evaluation Gériatrique Standardisée) score, patients aged ≥70 y 
had statistically significantly more disability, higher CCI score, underwent radiotherapy and chemotherapy less often, and had symptomatic treatment more compared with the patients aged <70 y. Those who were frail (Balducci classification) received more treatment consisting of only radiation compared with those classified as fit or vulnerable, whereas those classified as fit most often received chemotherapy alone or in combination with surgery and radiation NR

*NA = not applicable; NR = not reported; aCGA = abbreviated geriatric assessment; ADL = activities of daily living; ADT = androgen deprivation therapy; AGS = American Geriatric Society; BDI = Beck Depression Inventory; BFI = Brief Fatigue Inventory; BMI = body mass index; BUN = blood urea nitrogen; CC = carboplatin and cyclophosphamide; CP = carboplatin and paclitaxel; CGA = comprehensive geriatric assessment; CCI = Charlson comorbidity index; CIRS-G = Cumulative Illness Rating Scale–Geriatric; DLCL = diffuse large cell lymphoma; ECOG = Eastern Collaborative Group Oncology; PS = performance status; ESL = English as a second language; FACT-B = Functional Assessment Cancer Treatment–Breast; GDS = Geriatric Depression Scale; GFI = Groningen frailty indicator; HADS = Hospital Anxiety and Depression Scale; IADL = instrumental activities of daily living; IQCODE = Informant Questionnaire on Cognitive Decline in the Elderly; IQR = interquartile range; KPS= Karnofsky Performance Status; MGA = multidimensional geriatric assessment; MMSE = Mini Mental State Examination; MNA = Mini Nutritional Assessment; NSI = nutritional risk screening; OARS = Older Americans Resources and Services; PACE = Preoperative Assessment of Cancer in the Elderly; PINI = Prognostic Inflammatory and Nutrition Index; PS = Performance Status; PPT = physical performance test; QOL = quality of life; SPMSQ = Short Portable Mental Screening Questionnaire; SPPB = Short Physical Performance Battery; TUG = Timed Up and Go test; VES-13 = Vulnerable Elder Survey-13 items; SIC = Satariano comorbidity index.

Location = inpatient or outpatient setting; timing of geriatric assessment = before, during, or after treatment.

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