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Clinical Trial
. 2015 Apr;20(4):379-85.
doi: 10.1634/theoncologist.2014-0247. Epub 2015 Mar 12.

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

Trevor A Jolly  1 , Allison M Deal  2 , Kirsten A Nyrop  2 , Grant R Williams  2 , Mackenzi Pergolotti  2 , William A Wood  2 , Shani M Alston  2 , Brittaney-Belle E Gordon  2 , Samara A Dixon  2 , Susan G Moore  2 , W Chris Taylor  2 , Michael Messino  2 , Hyman B Muss  2
Affiliations
Clinical Trial

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

Trevor A Jolly et al. Oncologist. 2015 Apr.

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.

Keywords: Cancer; Geriatric assessment; Older; Performance status.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1.
Figure 1.
Karnofsky performance status ≥80, physical function for patients who scored 0 (“limited a lot”).
Figure 2.
Figure 2.
Karnofsky performance status ≥80, geriatric assessment-identified deficits. Abbreviations: BOMC, Blessed Orientation-Memory-Concentration test; IADL, instrumental activities of daily living; MHI, Mental Health Index; TUG, Timed Up and Go.
Figure 3.
Figure 3.
Karnofsky performance status ≥80, number of geriatric assessment-identified deficits.
Figure 4.
Figure 4.
Karnofsky performance status ≥80, social activity limitations.
See this image and copyright information in PMC

References

    1. SEER stat fact sheets: All cancer sites. Available at http://seer.cancer.gov/statfacts/html/all.html. Accessed February 20, 2015.
    1. U.S. Census Bureau projections show a slower growing, older, more diverse nation a half century from now. Available at http://www.census.gov/newsroom/releases/archives/population/cb12-243.html. Accessed February 20, 2015.
    1. Smith BD, Smith GL, Hurria A, et al. Future of cancer incidence in the United States: Burdens upon an aging, changing nation. J Clin Oncol. 2009;27:2758–2765. - PubMed
    1. Hurria A, Naylor M, Cohen HJ. Improving the quality of cancer care in an aging population: Recommendations from an IOM report. JAMA. 2013;310:1795–1796. - PubMed
    1. Mohile SG, Magnuson A. Comprehensive geriatric assessment in oncology. Interdiscip Top Gerontol. 2013;38:85–103. - PubMed

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