Prevalence and Predictors of Fatigue in Middle‐aged and Older Adults: Evidence From the Health and Retirement Study

There is a significant correlation between a QCS score less than 11 out of 15 and a MMSE score of 23 or less out of 30 (correlation coefficient 5 .783).In a study of a two-questions screening test for depression in patients without cognitive impairment (defined as a MMSE score !26), 7 a score of 1 or greater had a sensitivity of 84%, a specificity of 61%, and a NPV of 95% compared with a 15-item Geriatric Depression Scale (GDS-15) score of 5 or greater.To assess functional status, the Older Americans Resources and Services (OARS) questionnaire, with a score ranging from 0 to 28 8 and taking approximately 5 minutes to administer is the most used in North America.Although the cutoff is not clearly determined, each point under the maximum score indicates a functional disability that must be taken into account for further interventions or advises.The one-leg balance test is a short and simple test during which the patient has just to be able to stand up.9 The inability to perform this task doubles the risk for an injurious fall during the next 3 years.Concerning malnutrition, there is no validated test that can be routinely used in the ED, and the measurement of body mass index, frequently included in nutritional scores, is difficult to perform in the ED.It is also critical to take advantage of the ED visit to review and improve the medication list to reduce adverse drug events.The Beer's criteria are a widely accepted list that can help to identify potentially inappropriate medication in older patients and can be used to simplify treatments.10 In conclusion, older patients admitted to the ED should be screened for risk of adverse outcomes.In patients at high risk of adverse outcomes, the CGA should be administered with brief tools validated in the ED.This two-step intervention has been shown to decrease the rate of functional decline, readmission, and institutionalization.Further research is needed to validate this approach in different populations, such as in Europe or Asia.