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Table 2 Standardised multidimensional geriatric therapeutic programme in the intervention arm of the EGeSOR trial; ADL, Activities of Daily Living score; IADL, Instrumental Activities of Daily Living score; MNA, Mini-Nutritional Assessment; BMI, body mass index; MMSE, Mini-Mental State Examination; GDS, Geriatric Depression Scale; CIRS-G, Cumulative Illness Rating Scale-Geriatrics

From: Impact of comprehensive geriatric assessment on survival, function, and nutritional status in elderly patients with head and neck cancer: protocol for a multicentre randomised controlled trial (EGeSOR)

Domains Assessment tools – thresholds for interventions Standardised responses
Functional status ADL ≤5 Social services notification
  AND/OR Home care
  IADL ≤ 7 Access to geriatric network
Mobility/fall risk Falls during the last 6 months Walking and/or standing-balance rehabilitation (20 sessions)
  AND/OR AND
  One-leg standing test <5 seconds Fall management(1)
  AND/OR  
  Timed get-up-and-go test >20 seconds  
Nutritional status MNA ≤ 17 Nutritional care according to severity of malnutrition and swallowing disorders(2)
  AND/OR - Dietician visits
  Weight loss ≥5% in the last 3 months - High-energy and high-protein diet
  AND/OR - Nutritional supplements
  Weight loss ≥10% in the last 6 months - Enteral nutrition
  AND/OR - Monitoring of local/regional treatment prescribed by the ENT physician, including oral care(3)
  BMI < 21 Kg/m2 - Access to geriatric network
   - Education on disease self-management
Cognitive status MMSE ≤ 23 - Evaluation for causes of delirium and correction of predisposing factors(4)
   - Neuropsychological assessment with evaluation of memory
   - Access to geriatric network
Depression GDS-15 ≥ 6 - Antidepressant treatment(5)
   - Follow-up by a psychologist
   - Psychiatrist visit, depending on severity
   - Access to geriatric network
Co-morbidities CIRS-G: - Medication review and medication regimen optimisation(6)
  at least one co-morbidity (other than the HNSCC) grade ≥3 - Access to geriatric network
  AND/OR - Education on disease self-management:
  Number of drugs ≥5/day - Diabetes in the elderly: facts and management(7) - Atrial fibrillation: facts and management(8)
  Focus on five diseases: chronic atrial fibrillation, chronic systolic heart disease, diabetes, coronary artery disease, hypertension - Management of coronary heart disease in older adults(9)
   - Diagnosis and management of chronic systolic heart disease
  1. (1)Assessment and prevention of falls in older people – Practice guidelines. Online in April 2009.
  2. (2)Malnutrition in the elderly - Nutritional support strategy. Practice guidelines. Online in June 2007.
  3. Physiotherapy - Preserving motor function in frail elderly people living at home Practice guidelines. Online in April 2005.
  4. (3)Upper aerodigestive cancers - Practice guidelines ALD n°30. Online in November 2009.
  5. (4)Alzheimer's disease and related conditions - Diagnosis and treatment: Practice guidelines. Online in December 2011.
  6. (5)A workshop on psychotropic drug prescriptions in the elderly. Online in October 2007.
  7. (6)Improving the primary care prescription of hypnotic and anxiolytic drugs in the French elderly. Online in March 2009.
  8. (6)Improving drug prescription in older persons. Online in November 2012.
  9. (7)Guidelines for the management and care of diabetes in the elderly. Online in January 2011.
  10. (8)Guidelines for the management of patients with atrial fibrillation. Online in July 2007.
  11. All guidelines available at http://www.has-sante.fr/portail/jcms/fc_1249588/fr/accueil-2012/ Last accessed 27 December 2013.
  12. Expert consensus of the French Society for Geriatrics and Gerontology and French Society for Cardiology on the management of atrial fibrillation in elderly people (2013), at http://www.sfcardio.fr/.
  13. (9) Consensus of the French Society for Gerontology and Geriatrics and French Society for Cardiology for the management of coronary heart disease, at http://www.sfcardio.fr.
  14. (10) Therapeutic education in patients with chronic heart failure : proposal for multiprofessional structured programme by a French task force under the auspices of the French Society of Cardiology at http://www.sfcardio.fr.