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
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 |