Geriatric assessment-identified deficits in older cancer patients with normal performance status.

Academic Article

Abstract

  • BACKGROUND: We investigated whether a brief geriatric assessment (GA) would identify important patient deficits that could affect treatment tolerance and care outcomes within a sample of older cancer patients rated as functionally normal (80%-100%) on the Karnofsky performance status (KPS) scale. METHODS: Cancer patients aged ≥65 years were assessed using a brief GA that included both professionally and patient-scored KPS and measures of comorbidity, polypharmacy, cognition, function, nutrition, and psychosocial status. Data were analyzed using descriptive statistics and multivariable logistic regression. RESULTS: The sample included 984 patients: mean age was 73 years (range: 65-99 years), 74% were female, and 89% were white. GA was conducted before (23%), during (41%), or after (36%) treatment. Overall, 54% had a breast cancer diagnosis (n = 528), and 46% (n = 456) had cancers at other sites. Moreover, 81% of participants (n = 796) had both professionally and self-rated KPS ≥80, defined as functionally normal, and those patients are the focus of analysis. In this subsample, 550 (69%) had at least 1 GA-identified deficit, 222 (28%) had 1 deficit, 140 (18%) had 2 deficits, and 188 (24%) had ≥3 deficits. Specifically, 43% reported taking ≥9 medications daily, 28% had decreased social activity, 25% had ≥4 comorbidities, 23% had ≥1 impairment in instrumental activities of daily living, 18% had a Timed Up and Go time ≥14 seconds, 18% had ≥5% unintentional weight loss, and 12% had a Mental Health Index score ≤76. CONCLUSION: Within this sample of older cancer patients who were rated as functionally normal by KPS, GA identified important deficits that could affect treatment tolerance and outcomes.
  • Authors

    Published In

  • Oncologist  Journal
  • Keywords

  • Cancer, Geriatric assessment, Older, Performance status, Aged, Aged, 80 and over, Female, Geriatric Assessment, Humans, Karnofsky Performance Status, Male, Mental Health, Multivariate Analysis, Neoplasms, Social Behavior, Social Support
  • Digital Object Identifier (doi)

    Author List

  • Jolly TA; Deal AM; Nyrop KA; Williams GR; Pergolotti M; Wood WA; Alston SM; Gordon B-BE; Dixon SA; Moore SG
  • Start Page

  • 379
  • End Page

  • 385
  • Volume

  • 20
  • Issue

  • 4