Topic a Operationalisation Cut-off point



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Supplementary Data
Table 1 Content of the [G]OLD-instrument

Topic a

Operationalisation

Cut-off point

Decline in general health status b

Health in general (1 item SF-20)1; health status now compared to one year ago (1 item SF-36)2

N/A; health status somewhat worse or much worse than one year age

Complaints b

Whether person experienced any complaints in the past 1 or 2 months; three most important complaints

N/A

Polypharmacy

Number of prescribed drugs

Using ≥ 5 medications

Discrepancy medication use

Comparison registered medication (prescription) with actual medication use

Discrepancy between registered and actual medication use

Dependency in (I)ADL

GARS3: 18 items on the ability to perform activities of daily living (ADL) or instrumental activities of daily living (IADL)

Scored ‘only with assistance’ or ‘independent, but with great effort’ on at least one of the 18 items

Urine incontinence

Undesired loss of urine in past 3 months

Yes, undesired loss of urine

Faecal incontinence

Undesired loss of faeces in past 3 months

Yes, undesired loss of faeces

Impaired sight

Currently experiencing problems in daily living because of impaired sight; decrease in eyesight in the past 6 months

Difficulty to read newspaper; difficulty to recognize face at 4 meters distance4



Scored ‘yes’ on at least one of the 4 items

Impaired hearing

Currently experiencing problems in daily living because of impaired hearing; decreased hearing in the past 6 months; environment indicates impaired hearing

Scored ‘yes’ on at least one of the 3 items


Overweight

Body Mass Index (BMI) – overweight

BMI > 27

Underweight

Body Mass Index (BMI) – underweight

BMI < 20

Undesired weight loss

Whether person experienced undesired weight loss in past 3-6 months

Yes, undesired weight loss

Decreased appetite

Whether person experienced a loss of appetite in the past month

Yes, loss of appetite

Systolic BP > 140 mm Hg

Measurement of systolic blood pressure in mmHg

BPsyst > 140 mmHg

Diastolic BP > 90 mm Hg

Measurement of diastolic blood pressure in mmHg

BPdiast > 80 mmHg

Insufficient physical activity

Whether person is physically active on average 30 minutes per day, at least 5 days per week

No, physically active below the norm

Smoking

Whether person smokes

Yes, smokes

Excessive alcohol use

Number of glasses of alcohol person drinks per occasion (including two additional items to obtain details on drinking behaviour)

Drinks 3 or more glasses of alcohol per occasion

Memory problems

Mini-cog test - mental status assessment of older adults5: clock-drawing test (scoring options: 0 (poor clock) to 5 (perfect clock)) and repeating three words

Incorrectly repeating all 3 words (irrespective of score on clock-drawing test) OR 1 or 2 words incorrect, but score on clock-drawing test of 4 or less

Anxiety

Part A of Hospital Anxiety and Depression Scale (HADS)6 – 7 items

Score ≥ 8 (range 0-21)

Depressive complaints

5 items Geriatric Depression Scale (GDS)7: dissatisfaction; boredom; feelings of helplessness; prefers to stay at home; feelings of worthlessness

Score ≥ 2 (range 0-5)

Personality disorder

3 items from Gerontologic Personality Disorders Scale (GPS)8: intention to end life; suffering from nervousness, tension; used sleeping pills in the past

Score ≥ 2 (range 0-3)

Fall incidents in past 6 months

Number of falls past 6 months


≥ 1 falls past 6 months


Concerned about falling

Whether person is ever concerned about falling

Often or very often concerned to fall

Avoidance of activities due to fear or falling

Whether person avoids certain activities due to fear of falling

Often or very often avoidance of activities

Decreased mobility

Get-up and go test9

Score ≥ 3 (range 0-5)

Unsatisfied with daily routines

Whether person is satisfied with daily activities or routines

Mostly not or totally not satisfied with daily activities or routines

Loneliness

6-item loneliness scale10

Score ≥ 3 (range 0-6)

Burdened by informal care giving

Whether person experiences informal care giving as a burden

Sometimes, often or always burdened by informal care giving

Concerned about informal caregiver

Whether person is concerned about the informal caregiver

Yes, concerned about informal caregiver

Absence of social network

Whether a social network is present

No, social network is absent

Financial problems

Whether person had financial problems in the past 12 months

Yes, financial problems

Quality of life b

Self-reported quality of life (grade 1–10)

Grade of 5 or less

N/A means not applicable.

a In the same order as they appear in the [G]OLD-instrument.

b Not included in prevalence rates or sum scores in the current study, since these topics do not represent a distinctive problem and may be related to other topics in the [G]OLD-instrument.
References
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2 Van der Zee KI, Sanderman R. Het meten van de algemene gezondheidstoestand met de RAND-36: een handleiding [Measurement of general health status with the RAND-36: a guideline]. Groningen: Rijksuniversiteit Groningen, Noordelijk Centrum voor Gezondheidsvraagstukken;1993.

3 Kempen GIJM, Doeglas DM, Suurmeijer TPBM. Het meten van problemen met zelfredzaamheid op verzorgend en huishoudelijk gebied met de Groningen Activiteiten Restrictie Schaal (GARS): een handleiding [Measurement of disability in activities of daily living and instrumental activities of daily living with the Groning Activity Restriction Scale (GARS): a guideline]. Groningen: Rijksuniversiteit Groningen, Noordelijk Centrum voor Gezondheidsvraagstukken;1993.

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6 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70.

7 Hoyl MT, Alessi CA, Harker JO et al. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc 1999;47:873-78.

8 Van Alphen SP, Engelen GJ, Kuin Y, Hoijtink H, Derksen JJ. Constructie van een schaal voor de signalering van persoonlijkheidsstoornissen bij ouderen [Construction of a scale to detect personality disorders in older people]. Tijdschr Gerontol Geriatr 2004;35:186-95.

9 Mathias S, Navak US, Isaacs B. Balance in elderly patients: The “get-up and go” test. Arch Phys Med Rehabil 1986;67:387-89.

10 De Jong Gierveld J, Van Tilburg T. A 6-Item scale for overall, emotional, and social loneliness. Confirmatory tests on survey data. Res Aging 2006;28:582-98.




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