This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
More than half of new cancers occur in people aged 70 or over. Some are as fit as people decades younger; others are frail, with weight loss, memory problems or many medicines. Frailty changes how well treatment is tolerated, so oncologists need a quick way to find the patients who need a full comprehensive geriatric assessment. The G8 questionnaire, developed in France by Bellera, Soubeyran and colleagues in the Oncodage study and published in 2012, does that in a few minutes.
The eight items
| Item | Scoring |
|---|---|
| Decline in food intake over 3 months | severe 0, moderate 1, none 2 |
| Weight loss over 3 months | more than 3 kg 0, does not know 1, 1 to 3 kg 2, none 3 |
| Mobility | bed or chair bound 0, out of bed but does not go out 1, goes out 2 |
| Neuropsychological problems | severe dementia or depression 0, mild 1, none 2 |
| Body mass index | under 19: 0; 19 to 21: 1; 21 to 23: 2; 23 or more: 3 |
| More than 3 prescription drugs a day | yes 0, no 1 |
| Self-rated health compared with peers | not as good 0, does not know 0.5, as good 1, better 2 |
| Age | over 85: 0; 80 to 85: 1; under 80: 2 |
The first six items come from the Mini Nutritional Assessment. The total ranges from 0 to 17.
Example
An 82-year-old with a good appetite, stable weight, who goes out, has no memory or mood problems, a BMI of 25, takes five medicines a day and rates their health as good as their peers’ scores 2 + 3 + 2 + 2 + 3 + 0 + 1 + 1 = 14: abnormal.
Interpretation
- 14 or less: abnormal. A comprehensive geriatric assessment is recommended before treatment decisions.
- Above 14: normal. Standard oncology care can usually go ahead.
In the Oncodage study, the G8 had a sensitivity of about 85% for detecting a geriatric problem. ASCO and the International Society of Geriatric Oncology (SIOG) recommend screening with a tool such as the G8 for patients 65 or older.
What the full assessment covers
A geriatrician looks at function, falls, nutrition, cognition, mood, other illnesses, medicines and social support, then suggests adjustments: treatment dose, physical therapy, nutrition support or help at home.
Limits
The G8 is a screening tool: it finds who needs a closer look, not what to change. It is less specific than sensitive, so many patients with an abnormal score turn out to be fit enough for standard treatment.