Comprehensive geriatric assessment in older adults with cancer: Recommendations by the Italian Society of Geriatrics and Gerontology (SIGG)

Abstract

Introduction Optimizing the approach to older adults with cancer is now a priority given the increasing frequency of new cancer diagnoses that are made in the older population. The comprehensive geriatric assessment (CGA) represents the gold‐standard for (1) defining prognosis and ability to withstand cancer treatments, (2) exploring the multiple aspects that define the complexity of frail older persons, and (3) designing person‐tailored interventions. Materials and methods In this document, based on a comprehensive revision of the literature, the Italian Society for Geriatrics and Gerontology proposes a CGA model (ONCOGER CGA) to be adopted by oncology centers for their routine approach to older patients with cancer. Results and discussion A widespread use of this standardized CGA format will facilitate comparisons across institutions, promote studies based on a multidimensional patient assessment, and foster the inclusion of geriatric endpoints in oncological clinical trials. Furthermore, we predict that the use of a standardized CGA approach will increase the integration of geriatricians into oncology care teams with the final result of improving therapeutic choices and clinical outcomes.

Different Impact of Definitions of Sarcopenia in Defining Frailty Status in a Population of Older Women with Early Breast Cancer

“…Anthropometric measures (weight, height, body mass index) were collected for all patients. The comprehensive geriatric assessment (CGA) was based on recommendations from SIOG and national clinical guidelines [38]. The following areas were evaluated: performance status by Eastern Cooperative Oncology Group (ECOG) [39,40], comorbidity burden by the Charlson Comorbidity Index [41], functional status by Activity of Daily Living (Katz ADL) [42] and by Instrumental Activities of Daily Living (Lawton IADL) [43], cognition by Mini-Mental State Examination (MMSE) [44], nutritional status by Mini Nutritional Assessment (MNA) [45], mood by Geriatric Depression Scale (GDS) [46], physical performance by Short Physical Performance Battery (SPPB), gait speed and time up-and-go test (TUGT) [47][48][49], muscular strength by handgrip (Jamar dynamometer) [50] and chair stand test [51].…”

A randomized clinical study on the impact of Comprehensive Geriatric Assessment (CGA) based interventions on the quality of life of elderly, frail, onco-hematologic patients candidate to anticancer therapy: protocol of the ONCO-Aging study

“…Elderly patients present specific age-related conditions that may increase the risk of complications from antitumor therapy and compromise prognosis and QoL [7]. The ONCO-Aging trial is designed to assess whether the inclusion of a CGA and CGA based interventions, results into an amelioration of QoL, in onco-hematological patients receiving innovative target agents or treatment schedule including RT and CT.…”

“…Elderly patients often require tailored and different strategies compared to their younger counterparts [5][6][7]. In fact, aging is associated with decreased physiological reserves and altered pharmacokinetics, reducing treatment tolerability and enhancing the risk of treatmentrelated adverse events.…”

Exploring Cost-Effectiveness of the Comprehensive Geriatric Assessment in Geriatric Oncology: A Narrative Review

“…Conceived in the 1960s, the Comprehensive Geriatric Assessment (CGA) is "a multidisciplinary process which includes assessment and management of assessed need" of older patients in relation to "medical, social and functional needs", ending in "the development of an integrated/coordinated care plan to meet those needs" [1]. The CGA comprises different scales to evaluate each health dimension, and single geriatric screening tools are often adopted as alternatives to a full CGA, enabling a brief CGA [2,3]. The CGA has a strong prognostic value and is essential to identifying older adults at risk of a disability.…”