Geriatric assessment-informed treatment decision making and downstream outcomes: what are the research priorities?

Geriatric assessment (GA) can predict outcomes relevant to patients and clinicians but is not widely used. The objective of this review is to summarize the evidence supporting use of GA to facilitate decision making and improve outcomes and identify gaps that need to be addressed to further bolster the rationale for the use of GA.

Recently several randomized controlled studies exploring the impact of GA-directed care have been reported. Although GA-directed care has not been shown to improve survival, it can decrease moderate to severe toxicity from chemotherapy, increase the likelihood of completing planned chemotherapy and improve quality of life without adversely affecting survival. In the surgical setting, GA-directed care may decrease duration of hospitalization, but does not affect rates of re-hospitalization.

GA-directed care can improve patient-important outcomes compared to usual care. However, more research on whether these findings apply to other contexts and whether GA-directed care can improve other outcomes important to patients, such as function and cognition, is needed. Also more clarity about how oncologic treatments should be modified based on results of a GA are needed if oncologists are to utilize this information effectively to obtain the reported results.