Table 2.

Instruments and scoring of the consensus-based nephrology-tailored geriatric assessment

Domain	Instrument	Executed by	Explanation	Score/cut-off	Duration (minutes)
Functional status	Activities of daily living (Katz ADL-6) [25]	P	Grading of dependency on 6 functions, e.g., bathing, dressing, feeding	0–6 b, ≥ 2 indicates dependency	2
	Instrumental Activities of daily living (Lawton) [26]	P	Grading of dependency on 8 more complex functions, e.g., ability to use telephone, housekeeping, medication	0–8 for women, 0–5 for men. Higher scores indicate more independency, no cut-off point	2
	Handgrip strength	I	Best of 3 repetitive measurements with dominant hand (i.e., no vascular access)	Reference value depending on age and gender [62]	4
	Fall risk assessment	I	1-year fall history and fear of falling	Yes/no; 1 (‘no fear’) to 10 (‘very afraid’)	1
Cognitive functioning	Montreal Cognitive Assessment [29]	I	Screening for mild cognitive impairment in 8 domains (i.e., visuospatial, naming, memory, attention, language, abstraction, delayed recall, orientation)	0–30, < 26 indication of cognitive impairment	10
	6-item Cognitive Impairment Test [31]	I	6-item screening for dementia, assessing orientation, attention, and memory	0–28, ≥ 11 indication of cognitive impairment	2–3
	Letter Digit Substitution Test [30]	I	Speed dependent task to measure speed of processing by matching letters to corresponding numbers provided in the key	Number of correct substitutions at 60 s; reference values depend on age, gender, education level [63]	5
Psychological status/mood	Whooley questions/Geriatric Depression Scale-15 [33, 34]	Ia	Two initial question on depressed mood and anhedonia in the past month If yes on at least one question, 15-item GDS assesses presence and degree of depressive symptoms	Yes/no 0–15, (≥ 6 indicative of depression) [64]	1 5–7
	Life Orientation Test-Revised [35]	P	Dispositional optimism is measured by 10 items (including 4 filler items). Calculation of a total score, or the pessimism (reversed score on items 3, 7, 9) and optimism (items 1,4, 10) constructs separately	0 (‘strongly disagree’) to 4 (‘strongly agree’) 0–24 total score, or 0–12 per construct. Higher scores indicate more optimism, reference values depend on age and gender [65]	< 3
Patient reported outcome measures	HRQoL: 12-item Short Form Health Survey [41]	P	12 items on HRQoL providing a mental component summary (MCS) and physical component summary (PCS), using three- or five-point Likert scales	0–100, higher scores indicating better HRQoL	≤ 2 c
	Dialysis Symptom Index [42]	P	Measuring symptom burden, by indicating presence of 30 or any other additional symptoms. If present, patients are asked to specify for the degree of bothersome	Yes/no, if yes 1 (‘not at all’) to 5 (‘very much’)	2–15 c
Somatic status	Surprise question [40]	C	Clinicians response to the question: “Would I be surprised if the patient died in the next 12 months?” assessed by nephrologist, geriatrician and/or nurse (practitioner)	Yes/no	1
	Clinical Frailty Score [36],	C	Clinical judgement on a visual and written chart with 9 graded pictures. d	1 (‘very fit’) to 9 (‘terminally ill’)	< 1
	Charlson Comorbidity Index [37]	C	Comorbid conditions weighted for increased severity of the condition	1 to 6 points per condition, total range of 0–33	4
	Polypharmacy	C	Assessed by means of the total number of different medication for chronic use (i.e., for more than 2 weeks)	Use of five or more medications daily	2
Nutrition	Patient-Generated Subjective Global Assessment [45]	P P/I	Short Form includes 4 self-reported items on weight development, food intake, symptoms, and activities Complete PG-SGA: 5 additional items to be filled in by a clinician or dietician (diagnosis, age, metabolic stress, physical examination) to assess numerical score	Short Form only: 0–36 (≥ 6 indicates malnutrition) Complete PG-SGA: 0–52 (≥ 9 indicates malnutrition)[46]	1 5–10
Social	Caregiver burden: EDIZ-plus [47]	CG	Self-perceived burden from informal care measured in 15-statements to ‘agree’, ‘neither agree/nor disagree’ or ‘disagree'	1 point per question answered with ‘agree’; 0 (‘no burden’), 1–3 (‘minor burden’), 4–8 (‘moderate burden’), 9–15 (‘severe burden’)	5

P patient, I interviewer, C clinician, CG caregiver, NA not available, HRQoL health-related quality of life, EDIZ Ervaren Druk door Informele Zorg [Self-perceived burden from informal care]

^aGDS can be either self-administered or by an interviewer, for more in-depth assessment interviewer-administered is preferred

^bScore range 0–12 for the ternary-answering version

^c12 min on average for both measures

^dThe initial seven-point scale version was expanded to a nine-point scale by the authors of the clinical fraily scale