Table 1.
The comprehensive geriatric assessment, results and interventions.
| Domain | Assessment and screening tool | Possible interventions | Interventions implemented | ||||
|---|---|---|---|---|---|---|---|
| Cut-off | Score | n (%) | n (%) | ||||
| Comorbidity | CIRS-G | – |
0–4 5–7 |
11 (15) 31 (44) |
Optimising treatment Referrals to exams/other departments | Referrals | 23 (32) |
| Review of medical records | ≥8 | 29 (41) | |||||
| Clinical examination | |||||||
| Patient interview | |||||||
| Medication review | No. of medications/polypharmacy | – | 0–4 | 43 (61) | Discontinuation | Changes in medication | 44 (62) |
| ≥5 | 28 (39) | Prescription | |||||
| START/STOP criteria | Change in dosage | ||||||
| Cognitive function | MMSE | ≤23/30 | 24–30 | 71 (100) | Further evaluation | Cognitive evaluation | 1 (1.4) |
| 0–23 | 0 (0) | Referral/medication | |||||
| Psychological function | GDS | ≥ 6/ 15 | 0–5 | 67 (9) | Assessment of possible depression | Medical treatment | 2 (2.8) |
| ≥6 | 4 (6) | Referrals | 2 (2.8) | ||||
| Nutritional status | MNA-based local nutritional screening | Weight loss ≥5% | 0–5 | 18 (25) | Nutritional supplements | Referral: GERICO dietitian | 36 (51) |
| ≥5 | 53 (75) | Referral to dietitiana | |||||
| Physical function | Gait speed 10 m | >1 m/s | 0–1 | 37 (52) | Referral to the exercise programmeb | Referral: GERICO exercise programme | 28 (39) |
| >1 | 32 (45) | ||||||
| Handgrip strength (Jamar Dynamometer) | <♀ 20 kg | below | 35 (49) | Referral to the exercise training programmeb | Referral: GERICO exercise programme | 28 (39) | |
| <♂ 30 kg | above | 36 (51) | |||||
| Functional status | Katz ADL | <6 | 6 | 62 (87) | Initiation of home care | Initiation of social support | 2 (2.8) |
| (In)dependence | 0–5.5 | 9 (13) | Occupational therapy assessment | Occupational therapy | 2 (2.8) | ||
| FAQ IADL | >1 | 0 | 48 (68) | Initiation of home care | Initiation of home care | 2 (2.8) | |
| (In)dependence | ≥1 | 23 (32) | Transport arrangement | ||||
| Laboratory parameters | TSH, cobalamin, folate, albumin, vitamin D | Normative values | Normal | 51 (72) | Treat deficiencies/control blood samples | Deficiencies treated | 20 (28) |
| abnormal | 20 (28) | ||||||
ADL activities of daily living, CIRS-G Critical Illness Rating Score—Geriatrics, FAQ IADL frequently asked questions instrumental activities of daily living, GDS Geriatric Depression Scale, MMSE minimal mental state examination, MNA minimal nutritional assessment.
aA personalised nutritional plan based on the patient’s taste preferences and a telephone follow-up call after 1 month, and 3 months after chemotherapy discontinuation.
bThe exercise programme included 24 supervised exercise sessions preferably twice weekly at the hospital and home exercise once weekly. The supervised exercise was a 1-h training programme including 15 min of warming up with aerobic and balance training, 30 min of resistance training, and finally 15 min of supervised relaxation.