The Cumulative Illness Rating Scale for Geriatrics CIRS(G) was developed by Miller et al based on the Cumulative Illness Rating Scale of Linn et al. This can be used to measure the burden of current and chronic illnesses in the older adult. The authors are from the University of Pittsburgh.


Body systems evaluated:

(1) heart

(2) vascular

(3) hematopoietic

(4) respiratory

(5) EENT (eyes, ears, nose, throat, larynx)

(6) upper GI tract

(7) lower GI tract

(8) liver

(9) renal

(10) genito-urinary (ureters, bladder, urethra, prostate, genitals)

(11) musculoskeletal / integument

(12) neurological

(13) psychiatric illness

(14) endocrine / metabolic


Differences from the original CIRS:

(1) addition of hematopoietic item

(2) addition of breast to endocrine/metabolic


Degree of Severity


no problem


mild current problem or past significant problem


moderate disability or morbidity; requires "first line" therapy


severe or constant significant disability; uncontrollable chronic problem


extremely severe (life threatening), end organ failure, severe impairment in function



total score =

= SUM(points for number of body systems evaluated)


severity index =

= (total score) / (number of body systems evaluated)


Additional tabulations:

(1) number of body systems with severity grade 3

(2) number of body systems with severity grade 4



• minimum total score: 0

• maximum total score: 56

• minimum severity index: 0

• maximum severity index: 4



• The scale showed good inter-rater reliability with intraclass correlation coefficients in range 0.78 to 0.88.

• The scale correlated with the physician's estimate of global disease burden. It also correlated with disability as measured with the Older Americans Activities of Daily Living Scale.



• It may be difficult to accurately convey the burden of multiple conditions by using a single index.

• A person could have multiple problems within a single body system. One way to handle this would be to move to a higher score if two or more conditions of similar magnitude are present.


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