Routine clinical care pathway and study in older patients needing intensive treatment

Rationale: Aging is accompanied by an increased vulnerability with a consequently higher risk of disease and death. However, older patients are characterized by a high degree of heterogeneity and calendar age alone is a poor marker of individual vulnerability or vitality. A solid measurement of this vitality is especially essential in decision-making in older patients needing invasive treatments like surgery, radiation or chemotherapy. Conventional geriatric assessment of physical, psychological and social function likely yields valuable predictors, but validated predictors have not been firmly established in the clinical setting. Furthermore, novel markers of biological age and vitality have been identified in various studies (serum biomarkers and measurement of physical activity using accelerometers) and hold great promise, but have sparsely been tested in in the clinical setting.

Objective: The aim is to study the association between geriatric assessment and treatment outcomes in older patients who are candidate for intense treatments for various diseases. This could lead to a prediction of clinical outcomes in older patients visiting the hospital, using a mix of routine clinical parameters and biomarker-derived measurements.

Study design: A multicenter prospective observational cohort study.

Study population: Patients aged ≥70 years needing invasive treatment.

We hypothesize that geriatric screening is helpful in clinical decision making for the older patients needing invasive treatment.

T0: inclusion, T1: 6 months, T2 12 months.

This study is not a clinical trial, no intervention is predefined. We follow the standard care procedures. Next to that, pre-geriatric screening using Geriatric-8 (G8) and the six item cognitive impairment test (6-CIT). In case of abnormalities a comprehensive geriatric assessment will be obtained.