Mailed geriatric assessment

Domain	Measures
Functional status	1) Activities of Daily Living [Subscale of the EORTC QLQ-C30]
	2) Instrumental Activities of Daily Living [Subscale of the OARS]
	3) Exercise scale
Comorbidity	Physical Health Section [Subscale of the OARS]
Pain	Visual Analog Pain Thermometer Scale
Psychological	Hospital Anxiety and Depression Scale
Financial well-being	Subscale of the OARS
Social support	Medical Outcomes Study Social Support Survey
Spiritual well-being	Symptoms of Belief Inventory
Quality of life	EORTC QLQ-C30

Mailed_geriatric_assessme.htm

Also captures information on demographics.

OARS: Older American Resources and Services.

Graphic 60695 Version 2.0