Domains assessed and examples of validated tools as part of a full GA
| . | Components . | Tools/measurements . | Definition of impairment (when applicable, studies of HL are referenced) . |
|---|---|---|---|
| Functional status* | Katz ADL | Bathing, dressing, maintaining continence, transferring, going to the toilet, and feeding | Dependence on ≥1 ADL |
| Associated with worse overall survival (OS) in HL15 | |||
| Lawton instrumental ADL | Ability to use telephone, shopping, managing medications, housekeeping, preparing meals, laundry, transportation, and managing finances | Assistance required with or dependence on ≥1 instrumental ADL | |
| Associated with worse progression-free survival (PFS) and OS in HL26 | |||
| Falls | — | ≥1 self-reported fall in the previous 6 mo | |
| Objective physical performance (eg, Timed “Up and Go”) | Ability to get out of a chair and walk 3 m | A score ≥ 12 indicates that the patient is at risk for falling | |
| Comorbidities* | CIRS-G55 | Scores diseases in 14 organ systems and grades each according to severity with rules for classification | A score > 10 |
| Associated with worse event-free survival and PFS in HL (univariate)26 | |||
| Charlson Comorbidity Index | Consists of 19 comorbidities weighted according to their influence on mortality | ≥2 comorbidities (adapted Charlson) | |
| Associated with inferior outcomes in HL17,24 | |||
| Psychological health | Depression (eg, Geriatric Depression Scale-15) | 15-item self-reported assessment | A score > 5 suggests presence of depression |
| Cognition | Mini-Cog | Assesses word recall and clock draw | A score < 3 suggests dementia |
| Blessed Orientation Memory Concentration | Assesses orientation, memory, and concentration | A score ≥ 6 suggests moderate impairment; a score ≥ 11 suggests severe impairment. | |
| Nutritional status | Weight loss | — | Unintentional weight loss > 10% in the past 6 mo |
| Body mass index | — | <21 kg/m2 | |
| Polypharmacy | Number of medications | Scheduled and/or as needed medications | ≥5 medications |
| Potentially inappropriate medications | Beers criteria56 | — | |
| Social support | Presence of caregivers | — | — |
| Medical Outcomes Study Social Support and Social Activity Survey57 | Assesses perceived social support and social activity limitations due to health | — | |
| Geriatric syndromes | Dementia, delirium, osteoporosis, falls, failure to thrive, sarcopenia, pressure ulcer, incontinence, neglect/abuse | — | Presence of any syndrome |
| . | Components . | Tools/measurements . | Definition of impairment (when applicable, studies of HL are referenced) . |
|---|---|---|---|
| Functional status* | Katz ADL | Bathing, dressing, maintaining continence, transferring, going to the toilet, and feeding | Dependence on ≥1 ADL |
| Associated with worse overall survival (OS) in HL15 | |||
| Lawton instrumental ADL | Ability to use telephone, shopping, managing medications, housekeeping, preparing meals, laundry, transportation, and managing finances | Assistance required with or dependence on ≥1 instrumental ADL | |
| Associated with worse progression-free survival (PFS) and OS in HL26 | |||
| Falls | — | ≥1 self-reported fall in the previous 6 mo | |
| Objective physical performance (eg, Timed “Up and Go”) | Ability to get out of a chair and walk 3 m | A score ≥ 12 indicates that the patient is at risk for falling | |
| Comorbidities* | CIRS-G55 | Scores diseases in 14 organ systems and grades each according to severity with rules for classification | A score > 10 |
| Associated with worse event-free survival and PFS in HL (univariate)26 | |||
| Charlson Comorbidity Index | Consists of 19 comorbidities weighted according to their influence on mortality | ≥2 comorbidities (adapted Charlson) | |
| Associated with inferior outcomes in HL17,24 | |||
| Psychological health | Depression (eg, Geriatric Depression Scale-15) | 15-item self-reported assessment | A score > 5 suggests presence of depression |
| Cognition | Mini-Cog | Assesses word recall and clock draw | A score < 3 suggests dementia |
| Blessed Orientation Memory Concentration | Assesses orientation, memory, and concentration | A score ≥ 6 suggests moderate impairment; a score ≥ 11 suggests severe impairment. | |
| Nutritional status | Weight loss | — | Unintentional weight loss > 10% in the past 6 mo |
| Body mass index | — | <21 kg/m2 | |
| Polypharmacy | Number of medications | Scheduled and/or as needed medications | ≥5 medications |
| Potentially inappropriate medications | Beers criteria56 | — | |
| Social support | Presence of caregivers | — | — |
| Medical Outcomes Study Social Support and Social Activity Survey57 | Assesses perceived social support and social activity limitations due to health | — | |
| Geriatric syndromes | Dementia, delirium, osteoporosis, falls, failure to thrive, sarcopenia, pressure ulcer, incontinence, neglect/abuse | — | Presence of any syndrome |
Other measures to consider20 include estimates on risk for chemotherapy toxicity (eg, Cancer and Age Research Group Score58 and the Chemotherapy Risk Assessment Scale for High-Age Patients Score59 ) and estimates on noncancer life expectancy (eg, Schonberg Index or Lee Index60 ).
ADL, activities of daily living; CIRS-G, Cumulative Illness Rating Scale-Geriatric; OS, overall survival; —, no data.
Studies suggest that the GA domain is associated with outcomes in older HL patients.