Assessment domain | Assessment tool | Number of questions | How administered | Estimated time required (min) | Range: cut-off |
---|---|---|---|---|---|
Individual domains | |||||
Comorbidity | 18 | Medical Record Abstraction (MRA) | 5-10 | 0-43: ≥4 | |
Function | Vulnerable Elders Survey (VES-13) [29] | 12 | Self-report or Interviewer Administered | <5 | 0-10: ≥3 |
Psychosocial | Geriatric Depression Scale 5-item short form (GDS-5) [30] | 5 | Self-report or Interviewer | <5 | 0-5: ≥2 |
Modified MOS- Social Support Survey (mMOS-SS) [33] | 8 | Administered | <5 | 0-8: ≤2.5 | |
Nutrition | Mini Nutritional Assessment (MNA) [31] | 3 | Interviewer administered and MRA | <4 | 0-14: ≤11 |
Cognition | Mini-Cog [32] | 3 | Interviewer administered | 5 | 1-3 w/clock draw: 0 or 1–2 w/abnormal clock |
SAKK C-SGA | Â | Â | Â | Â | Â |
5 Domains | Six Measures: CCI, VES-13, GDS-5, mMOS-SS, MNA, Mini-Cog | 22– Patient 20– MRA | Self-report, Interviewer Administered, MRA | <30 | 0-5: ≥3 |