Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study Service organization, utilization, and delivery of care

Deckx, Laura, van den Akker, Marjan, Daniels, Liesbeth, De Jonge, Eric T., Bulens, Paul, Tjan-Heijnen, Vivianne C. G., van Abbema, Doris L. and Buntinx, Frank (2015) Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study Service organization, utilization, and delivery of care. BMC Family Practice, 16 1: . doi:10.1186/s12875-015-0241-x


Author Deckx, Laura
van den Akker, Marjan
Daniels, Liesbeth
De Jonge, Eric T.
Bulens, Paul
Tjan-Heijnen, Vivianne C. G.
van Abbema, Doris L.
Buntinx, Frank
Title Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study Service organization, utilization, and delivery of care
Journal name BMC Family Practice   Check publisher's open access policy
ISSN 1471-2296
Publication date 2015-03-01
Sub-type Article (original research)
DOI 10.1186/s12875-015-0241-x
Open Access Status DOI
Volume 16
Issue 1
Total pages 12
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted 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.
Keyword Functional status
Geriatric oncology
Longitudinal study
Neoplasms
Quality of life
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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