Prognostic Indices for Older Adults

Abstract

Quiz Ref ID Failure to consider prognosis in the context of clinical decision making can lead to poor care. Hospice is underutilized for patients with nonmalignant yet life-threatening diseases.¹ Healthy older patients with good prognosis have low rates of cancer screening.² Older adults with advanced dementia or metastatic cancer are screened for slow-growing cancers that are unlikely to ever cause them symptoms but may lead to distress from false-positive results, invasive workups, and treatments.^3,4 In recognition of these phenomena, guidelines increasingly incorporate life expectancy as a central factor in weighing the benefits and the burdens of tests and treatments (Table 1). Prognostic indices offer a potential role for moving beyond arbitrary age-based cutoffs in clinical decision making for older adults.² However, little is known about the quality of prognostic indices for older adults, limiting their clinical use.