Limits...
Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study.

Deckx L, van den Akker M, Daniels L, De Jonge ET, Bulens P, Tjan-Heijnen VC, van Abbema DL, Buntinx F - BMC Fam Pract (2015)

Bottom Line: Abnormal scores of all screening tools were significantly associated with functional decline.In older persons with a relatively good prognosis, geriatric screening tools are of limited use in identifying persons at risk for decline in functional status or quality of life after one year.Hence, a geriatric screening tool cannot be relied on in isolation, but they do provide very valuable information and may prompt physicians to also consider different aspects of functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice, KU Leuven, Kapucijnenvoer 33, bus 7001, 3000, Leuven, Belgium. Laura.deckx@med.kuleuven.be.

ABSTRACT

Background: Geriatric screening tools are increasingly implemented in daily practice, especially in the oncology setting, but also in primary care in some countries such as the Netherlands. Nonetheless, validation of these tools regarding their ability to predict relevant outcomes is lacking. In this study we evaluate if geriatric screening tools predict decline in functional status and quality of life after one year, in a population of older cancer patients and an older primary care population without cancer with a life expectancy of at least six months.

Methods: Older cancer patients and a general older primary care population without a history of cancer (≥ 70 years) were included in an on-going prospective cohort study. Data were collected at baseline and after one-year follow-up. Functional decline was based on the Katz Index and Lawton IADL-scale and was defined as deterioration on one or more domains. Decline in quality of life was measured using the global health related subscale of the EORTC QLQ-C30, and was defined as a decline ≥ 10 points. The selected geriatric screening tools were the abbreviated Comprehensive Geriatric Assessment, Groningen Frailty Indicator, Vulnerable Elders Survey-13, and G8. We calculated sensitivity, specificity, predictive values, and odds ratios to assess if normal versus abnormal scores predict functional decline and decline in quality of life.

Results: One-year follow-up data were available for 134 older cancer patients and 220 persons without cancer. Abnormal scores of all screening tools were significantly associated with functional decline. However, this was only true for older persons without cancer, and only in univariate analyses. For functional decline, sensitivity ranged from 54% to 71% and specificity from 33% to 66%. For decline in quality of life, sensitivity ranged from 40% to 67% and specificity from 37% to 54%.

Conclusion: In older persons with a relatively good prognosis, geriatric screening tools are of limited use in identifying persons at risk for decline in functional status or quality of life after one year. Hence, a geriatric screening tool cannot be relied on in isolation, but they do provide very valuable information and may prompt physicians to also consider different aspects of functioning.

No MeSH data available.


Related in: MedlinePlus

Flow-chart: population of the KLIMOP-study.
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Fig1: Flow-chart: population of the KLIMOP-study.

Mentions: The geriatric screening tools included the abbreviated Comprehensive Geriatric Assessment (aCGA), the G8, the Groningen Frailty Indicator (GFI), and the Vulnerable Elders Survey-13 (VES-13). In one hospital, data collection was integrated in a routine geriatric assessment, and therefore, data collection was slightly different in this hospital; here QoL, GFI and VES-13 were not assessed. Hence, for 35 older cancer patients no data were available for these measurements. We always indicate the number of patients included in the analyses and a detailed flowchart of the patient population is provided in Figure 1.Figure 1


Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study.

Deckx L, van den Akker M, Daniels L, De Jonge ET, Bulens P, Tjan-Heijnen VC, van Abbema DL, Buntinx F - BMC Fam Pract (2015)

Flow-chart: population of the KLIMOP-study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358725&req=5

Fig1: Flow-chart: population of the KLIMOP-study.
Mentions: The geriatric screening tools included the abbreviated Comprehensive Geriatric Assessment (aCGA), the G8, the Groningen Frailty Indicator (GFI), and the Vulnerable Elders Survey-13 (VES-13). In one hospital, data collection was integrated in a routine geriatric assessment, and therefore, data collection was slightly different in this hospital; here QoL, GFI and VES-13 were not assessed. Hence, for 35 older cancer patients no data were available for these measurements. We always indicate the number of patients included in the analyses and a detailed flowchart of the patient population is provided in Figure 1.Figure 1

Bottom Line: Abnormal scores of all screening tools were significantly associated with functional decline.In older persons with a relatively good prognosis, geriatric screening tools are of limited use in identifying persons at risk for decline in functional status or quality of life after one year.Hence, a geriatric screening tool cannot be relied on in isolation, but they do provide very valuable information and may prompt physicians to also consider different aspects of functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice, KU Leuven, Kapucijnenvoer 33, bus 7001, 3000, Leuven, Belgium. Laura.deckx@med.kuleuven.be.

ABSTRACT

Background: Geriatric screening tools are increasingly implemented in daily practice, especially in the oncology setting, but also in primary care in some countries such as the Netherlands. Nonetheless, validation of these tools regarding their ability to predict relevant outcomes is lacking. In this study we evaluate if geriatric screening tools predict decline in functional status and quality of life after one year, in a population of older cancer patients and an older primary care population without cancer with a life expectancy of at least six months.

Methods: Older cancer patients and a general older primary care population without a history of cancer (≥ 70 years) were included in an on-going prospective cohort study. Data were collected at baseline and after one-year follow-up. Functional decline was based on the Katz Index and Lawton IADL-scale and was defined as deterioration on one or more domains. Decline in quality of life was measured using the global health related subscale of the EORTC QLQ-C30, and was defined as a decline ≥ 10 points. The selected geriatric screening tools were the abbreviated Comprehensive Geriatric Assessment, Groningen Frailty Indicator, Vulnerable Elders Survey-13, and G8. We calculated sensitivity, specificity, predictive values, and odds ratios to assess if normal versus abnormal scores predict functional decline and decline in quality of life.

Results: One-year follow-up data were available for 134 older cancer patients and 220 persons without cancer. Abnormal scores of all screening tools were significantly associated with functional decline. However, this was only true for older persons without cancer, and only in univariate analyses. For functional decline, sensitivity ranged from 54% to 71% and specificity from 33% to 66%. For decline in quality of life, sensitivity ranged from 40% to 67% and specificity from 37% to 54%.

Conclusion: In older persons with a relatively good prognosis, geriatric screening tools are of limited use in identifying persons at risk for decline in functional status or quality of life after one year. Hence, a geriatric screening tool cannot be relied on in isolation, but they do provide very valuable information and may prompt physicians to also consider different aspects of functioning.

No MeSH data available.


Related in: MedlinePlus