DOMAIN

TOOL

SCORE SIGNIFYING IMPAIRMENT

Physical function

ADL

IADL

Falls history

Any ADL or IADL impairment

Any history of falls

Objective physical      performance

TUG

<10s Freely mobile

<20s Mostly independent

20-29s Variable mobility

>20s Impaired mobility

13.5s threshold for increased falls risk

Comorbidity

Charlson Comorbidity Index

Evaluated on a case-by-case basis

Nutrition

MNA-SF

Normal nutritional status 12-14

At risk of malnutrition (8-11 points)

Malnourished (0-7 points)

Social support

Patient history/caregiver interview

Any deficit noted

Polypharmacy

Number of total medications

≥5 medications

Psychological Status

GDS

Patient history/interview

10-19 mildly depressed

20-30 severely depressed

Cognition

MMSE

24-30=normal

Screening

G8

≤ 14