Practices | COPE study [15] | GOLD study [4]b | Routine care pathway, University Medical Centre Groningen |
---|---|---|---|
Focus group number | 1, 2 | 3, 4 | 5, 6 |
Type of practice | Prospective multicentre observational cohort study 4 year follow up | Prospective multicentre observational cohort study (cross-sectional geriatric assessment) | Routine care practice |
Aim of geriatric assessment | Examine the severity of cognitive impairment in older patients reaching ESKD before dialysis and the rate of decline after dialysis or CCM initiation | Assess the association of geriatric measures between start of dialysis and after 6 months | Guide patients to the best treatment choice and to define supplementary care to optimize quality of life and reduction of illness-related symptoms |
Population at inclusion | ≥65 years, eGFR ≤20 ml/min/1.73m2 | ≥65 years, initiating dialysis or conservative kidney management | ≥70 years (or younger if indicated), eGFR ≤20 ml/min/1.73m2 |
Measurements | Baseline: at inclusion Follow-up: yearly (four times), and after six months of start dialysis treatment | Baseline: within 4 weeks of initiating dialysis or 4 weeks after final decision to withhold Follow-up: after 6 months by phone | Yearly assessment divided over 2 or 3 visits |
Conducted by | Nurse practitioner or geriatric nurse | Research nurse | Nurse practitioner |
Duration | 3 h | 60–90 min | 2 × 30 min |
Location | Outpatient clinic | Home visit, follow-up by telephone | Outpatient clinic |
Use of outcomes of assessment | For study purposes and discussed in multidisciplinary meeting and with patient, if necessary referred for geriatric consult | Collected for study purposes only, at home or in dialysis centre | Discussed in multidisciplinary meeting and with patient |
Geriatric measures: | |||
 1. Functional status (ADL/ iADL) | GARSa Lawtona | Katz-6a Lawtona | Katza |
 2. Mobility | Gait speeda Hand grip strengtha Short Physical Performance batterya | Timed up and go Fallsa Four Test Balance Scale | Timed up and goc Fallsc |
 3. Cognition | Mini Mental State Examinationa Clock drawinga 15- WVLTa Stroop Colour Word Testa Trail making test (A&B)a Visual Association Testa Letter Digit Substitution Testa Assessment of numeracya | Mini Mental State Examination Clock drawing Enhanced Cued Recall Semantic Fluency Test | MOCAa |
 4. Mood | Geriatric Depression Scalea | Geriatric Depression Scale | Geriatric Depression Scalea |
 5. Nutritional status | Subjective Global Assessment or SNAQa | Mini-Nutritional Assessment | (anamnesis by dietician)a |
 6. Comorbidity | Charlson Comorbidity Indexa | CIRS-G | (anamnesis)a |
 7. Quality of Lifea | RAND-36a | EuroQol-5 | EuroQol-5Da Visual Analogue Scalea |
 8. Frailty | Fried frailty indicatora | Groningen Frailty Indexa Fried Frailty Index (includes 4 m walking test and Handgrip strength) | Rockwood Clinical Frailty score c |
 9. Caregiver burden | EDIZ-plusa | EDIZa | ([hetro]anamnesis by social worker) a |
 10. Estimation of nephrologist |  | VAS: overall condition Surprise question | Surprise question c |
 11. Other | Cantril’s ladder, Pain score, Anxiety score Illness perceptions questionnairea | Additional subjective cognition tests (by caregiver): IDDD a IQCODE a Neuro-Psychological Inventory a | Outcome Prioritization Tool (treatment goals) a |