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BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Laura Deckx, Marjan van den Akker, Liesbeth Daniels, Eric T De Jonge, Paul Bulens, Vivianne CG Tjan-Heijnen, Doris L van Abbema, Frank Buntinx

Published in: BMC Primary Care | Issue 1/2015

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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.
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Metadata
Title
Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study
Authors
Laura Deckx
Marjan van den Akker
Liesbeth Daniels
Eric T De Jonge
Paul Bulens
Vivianne CG Tjan-Heijnen
Doris L van Abbema
Frank Buntinx
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0241-x

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