Phenotyping older patients needing intensive treatment

Abstract

Higher age is accompanied with multimorbidity and is also associated with the presence of geriatric

conditions. A geriatric assessment (GA) is used to explore the domains of somatic status, mental,

physical and social functioning. Only few studies have assessed the association of a GA with

outcomes in older patients with severe diseases. We show that the majority of the studies in patients with head and neck cancer and esophageal cancer, reported a significant association of impairment in functional and cognitive performance, mood or social environment with a higher risk of adverse outcomes. Third, we investigated older patients reaching end-stage renal disease and reported that high age, low education, low functional status, frailty, higher burden of WMH and a history of vascular disease were associated with impaired cognitive function. Finally, we studied a patient reported outcome measurement (self-rated health; SRH) in older patients visiting the emergency department and show that it is at least partly dependent on factors of functional capacity and functional decline. In conclusion, we report that aspects of the GA are associated with adverse health outcomes. This endorses the importance of taking geriatric characteristics into account in patients who possibly need intensive treatment, however more research is needed.