Cancer and Aging Research Group

Improving the care of older adults with cancer

Practical Geriatric Assessment Results

Health & Wellness

Practical Geriatric Assessment Results

A structured summary of participant scores, identified impairments, and care-team discussion points.

Domains reviewed 6
Result status 
Next step Care-team review

Physical Function / Performance

Measure Items Definition of impairment Participant score
Falls Single item: falls in the last 6 months >1; falls
Physical Function Walking one block and climbing one flight of stairs Any limitation (a little or a lot)
Impairment in this domain 

Recommendations

  • Falls: check orthostatic blood pressure, review medications as appropriate, and offer falls-prevention information.
  • Weigh the risks and benefits of cancer-treatment options using physical-performance information.
  • Physical Therapy: request strength, balance, gait, and assistive-device evaluation.
  • Occupational Therapy: request evaluation and treatment for functional loss.

Functional Status

Measure Items Definition of impairment Participant score
OARS IADL 6-items IADL items (walking, transportation, meals, housework, medicines, money) Any IADL items with “some help” or “unable”
OARS ADL 3-items ADL items (in/out of bed, dressing, bath/shower) Any ADL items with “some help” or “unable”
Impairment in this domain 

Recommendations

  • Consider cancer-treatment modifications such as a single agent, a modified dose, a modified schedule, or more frequent toxicity checks.
  • Physical Therapy: request strength, balance, gait, and assistive-device evaluation.
  • Occupational Therapy: request evaluation and treatment for functional loss.

Nutrition / Weight Loss

Measure Items Definition of impairment Participant score
Single item from the G8 and MNA Weight loss during the past three months

  • no weight loss or less than 1 kg
  • weight loss between 1 and 3 kg (2.2 and 6.6 lbs)
  • weight loss greater than 3 kg (6.6 lbs)
 Weight loss greater than 3 kg (6.6 lb)
Impairment in this domain 

Recommendations

  • Discuss nutrition concerns and how treatment may affect nutrition.
  • Consider nutritional supplements, liberalizing calorie-restricted diets, small frequent meals, and high-protein/high-calorie snacks.
  • Consider referrals to a nutritionist, dentist, speech therapist for swallowing concerns, or a meal-delivery service.
  • Use caution with emetogenic regimens and consider aggressive anti-emetic support when clinically appropriate.

Social Support

Measure Items Definition of impairment Participant score
MOS Social Support Instrumental items 1-4 and emotional items 5-8 Any item answered ‘none,’ ‘a little,’ or ‘some of the time’
Impairment in this domain 

Recommendations

  • Discuss the adequacy and availability of support at home.
  • Discuss whom the patient can contact in an emergency.
  • Confirm that a documented health-care proxy is in the medical record.
  • Consider a social-worker, visiting-nurse, or home-health-aide referral, and consider a lifeline emergency service.

Psychological

Measure Items Definition of impairment Participant score
PROMIS Anxiety 4-item Summed raw score, range 4-20 Raw score of 11 or higher
Geriatric Depression Scale (GDS-5) One point for ‘no’ to item 1 and one point for ‘yes’ to items 2-5 Score of 2 or higher
Impairment in this domain 

Recommendations

  • Discuss mood history and prior treatment.
  • Consider psycho-oncology, psychiatry, spiritual-counseling, or palliative-care referrals as appropriate.
  • Consider pharmacologic therapy with the primary-care provider when appropriate.
  • Provide links to community resources and assess safety risks using the organization’s clinical protocol.

Comorbidity, Hearing, and Vision

Measure Items Definition of impairment Participant score
OARS Comorbidity No/yes summed (0-13)

Interference for each

 ≥3 conditions

Or any condition with a great deal of interference

Specific for any history of diabetes, heart disease, or liver/kidney disease
Hearing Single item Fair, poor, or totally deaf
Vision Single item Fair, poor, or totally blind
Impairment in this domain 

Recommendations

  • Communicate the cancer-care plan directly with the patient’s primary-care provider.
  • Discuss how comorbidities affect treatment risks and benefits; modify dosage or schedule when clinically appropriate.
  • For hearing: confirm use of hearing aids if indicated, consider specialist referral, and consider an assistive listening device during visits.
  • For vision: confirm use of glasses if indicated, review glaucoma screening, and consider referral to a vision specialist.