Canterbury DHB

Context

Geriatric Comprehensive Assessment

Basic geriatric assessment tools

The IADL score was devised by Lawton et al in 1969 and rates 8 activites with a point for independent function. The best possible score is 8/8. An online tool is available at https://www.neurotoolkit.com/lawton-iadl-scale/.

The Katz ADL score rates 6 activities with the best possible score 6/6.

The Barthel score is similar with ratings of 0, 5 and 10 giving a maximum score (fittest) of 100. An online tool is at https://www.mdcalc.com/barthel-index-activities-daily-living-adl.

The CIRS-G score rates co-morbidities from 0-4 for a maximum score (least fit) of 56. The online tool is at https://www.mdcalc.com/cumulative-illness-rating-scale-geriatric-cirs-g. When used as a pre-transplant tool the haematological disease being treated is not counted in the total score.

Comprehensive geriatric assessment tools

FIL Score

The Italian Lymphoma Foundation (FIL) score combines age, IADL, ADL, and CIRS-G and was a powerful prediction tool in older patients undergoing RCHOP-like treatment for DLBCL (Tucci, Martelli et al. 2015).

Patients were classified as fit if they were <80 and met all of the criteria; unfit if they were >80 and met the other criteria for being fit or <80 and met any of the other criteria for being unfit. All other patients were categorised as frail.

Definition of Three Geriatric Risk Categories

From Tucci, A., et al. (2015). "Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)." Leukemia & Lymphoma 56(4): 921-926.

The FIL score was also found to be a more powerful prediction tool than HCT-CI in patients >60 years undergoing allogeneic transplant (Polverelli, Tura et al. 2020).

About this Canterbury DHB document (818048):

Document Owner:

Andrew Butler (see Who's Who)

Last Reviewed:

December 2016

Next Review:

December 2018

Keywords:

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Topic Code: 818048