Surreal illustration symbolizing geriatric health assessment and colorectal cancer.

Frailty in Seniors: How a Simple Risk Score Can Predict Colorectal Surgery Outcomes

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"New research highlights the importance of geriatric assessments in predicting survival and complications following colorectal cancer surgery for older adults."

As we age, the landscape of healthcare becomes increasingly complex. For older adults facing colorectal cancer surgery, predicting how well they'll do post-operation is crucial. It’s not just about the cancer itself, but also about their overall health and resilience. New research from the Netherlands sheds light on this, demonstrating how a simple geriatric risk assessment can provide valuable insights into a patient's likely outcomes.

Colorectal cancer is a significant health concern, particularly among older populations. In fact, over half of all new diagnoses occur in people aged 70 or older. However, older adults are a diverse group. Factors like pre-existing conditions, physical fitness, and the presence of geriatric impairments can all influence how they respond to treatment. These impairments, often subtle, can decrease physiological reserves, making seniors more vulnerable to stressors and adverse outcomes following surgery.

Traditionally, doctors have relied on tools like the American Society of Anesthesiologists (ASA) score to assess patient risk before surgery. But these tools often don't capture the nuances of geriatric health. This is where geriatric assessments come in. By evaluating various aspects of an older person's health, such as their risk for delirium, undernutrition, falls, and physical impairments, healthcare providers can gain a more comprehensive understanding of their overall resilience.

What is the VMS Risk Score and How Does It Work?

Surreal illustration symbolizing geriatric health assessment and colorectal cancer.

The Dutch study focused on the VMS (Veiligheid Management Systeem) an easy-to-use risk assessment tool designed for hospitalized older adults. It evaluates four key areas:

Risk for Delirium: Assesses the likelihood of developing confusion or altered mental state.
Risk for Undernutrition: Identifies those at risk of malnutrition or nutritional deficiencies.
Risk for Physical Impairments: Evaluates physical limitations and difficulties with daily activities.
Risk for Falls: Determines the likelihood of experiencing falls, a major concern for older adults.

Each area is scored as either 0 (risk absent) or 1 (risk present). These individual scores are then added together to create a total risk score, ranging from 0 to 4. A low score indicates a lower risk, while a higher score suggests a greater likelihood of adverse outcomes.

Making Informed Decisions for a Healthier Future

The VMS risk score offers a valuable tool for healthcare providers and older adults facing colorectal cancer surgery. By incorporating this simple assessment into pre-operative evaluations, doctors can gain a more comprehensive understanding of a patient's overall health and resilience. This information can then be used to tailor treatment plans, optimize post-operative care, and engage in shared decision-making, ultimately leading to better outcomes and improved quality of life for older adults.

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Everything You Need To Know

What is the VMS risk score?

The VMS (Veiligheid Management Systeem) risk score is a tool designed for hospitalized older adults. It assesses the risk for delirium, undernutrition, physical impairments, and falls. Each of these areas is scored as either 0 (risk absent) or 1 (risk present), and the scores are added to create a total risk score ranging from 0 to 4. A higher score indicates a greater risk of adverse outcomes. The VMS risk score helps predict the likelihood of complications and long-term survival in elderly patients undergoing colorectal surgery.

Why is the VMS risk score important?

The VMS risk score is significant because it offers a simple yet effective way to evaluate the overall health and resilience of older adults. The score helps healthcare providers gain a more comprehensive understanding of a patient's condition beyond just their cancer diagnosis. This enables them to tailor treatment plans and optimize post-operative care, which can lead to improved outcomes and quality of life. Traditional tools like the ASA score often fail to capture the nuances of geriatric health, making the VMS risk score a valuable addition to pre-operative evaluations.

What are the key areas evaluated by the VMS, and why are they important?

The four key areas evaluated by the VMS are risk for delirium (likelihood of confusion or altered mental state), risk for undernutrition (identifying malnutrition or nutritional deficiencies), risk for physical impairments (evaluating physical limitations and difficulties with daily activities), and risk for falls (determining the likelihood of experiencing falls). Assessing these risks is crucial because older adults are more vulnerable to these conditions, and their presence can significantly impact surgical outcomes. By addressing these risks proactively, healthcare providers can improve patient care and reduce the likelihood of adverse events.

How does the VMS risk score help doctors make informed decisions?

The VMS risk score helps doctors make informed decisions by providing a comprehensive understanding of a patient's overall health. With this understanding, doctors can tailor treatment plans to address specific risks and optimize post-operative care. This may involve interventions such as nutritional support, physical therapy, or strategies to prevent delirium and falls. Involving patients in shared decision-making based on their risk score empowers them to participate in their care and make choices that align with their values and preferences.

Why are geriatric assessments important for older adults facing surgery?

Geriatric assessments, like the VMS risk score, are important because they help evaluate various aspects of an older person's health, such as the risk for delirium, undernutrition, falls, and physical impairments. These assessments capture the nuances of geriatric health, which traditional tools often miss. By understanding an older person's overall resilience, healthcare providers can gain insights into how they will respond to treatment and tailor care accordingly. This leads to better outcomes, improved quality of life, and more informed decision-making for older adults undergoing colorectal surgery.