The scale has been developed for use in geriatric and vulnerable samples and offers a simple, dichotomous response format; it has also been validated for use with persons with mild-to-moderate cognitive impairment [ 50– 50].
Apart from the fit patient with a metastatic setting of RCC who can be treated in the same way as younger patients, there is clearly a need for prospective assessment for very elderly patients, ie, those aged ≥ 80 years, and for patients considered to be vulnerable or frail on geriatric scales.
As described in the literature and as we have detailed earlier, geriatric patients are vulnerable during airway management.
30 Frail older people have multiple comorbidities, polypharmacy, and often exhibit cognitive and functional decline that renders them highly vulnerable to adverse drug reactions, geriatric syndromes, and hospitalizations.
In geriatric oncology, the Vulnerable Elders Survey (VES-13), 29 the Groningen Frailty Indicator, 30 the G8 instrument, 31 and the abbreviated CGA 32 are screening tools that help identify vulnerable patients who would benefit from a full CGA.
This finding may be explained by the older, vulnerable patients served at the geriatric department; these patients have reduced physical, social and cognitive functioning, and require care for longer periods of time [ 24].
These real world data suggest that more than half of ACE version I patients suffered from CI; that there is a more than 48-hour delay in implementing geriatric services for this vulnerable group, and that there is significant room for improving the pace and penetration of geriatric consultations and recommendations.
The geriatric nursing home population is vulnerable to acute and deteriorating illness due to advanced age, multiple chronic illnesses and high levels of dependency.
Examples are the abbreviated comprehensive geriatric assessment (aCGA) [ 10], the Vulnerable Elders Survey (VES-13) [ 11], the Groningen Frailty Index (GFI) [ 12], and the G8 [ 13] which has been included in the EORTC minimal Dataset [ 14].
The analysis of the situation of the Quebec GAU shows that this type of program plays an essential role in the hospital care given to the vulnerable elderly, whose complex problems require cutting-edge expertise in geriatric care.
