Premium
The Feasibility of Inpatient Geriatric Assessment for Older Adults Receiving Induction Chemotherapy for Acute Myelogenous Leukemia
Author(s) -
Klepin Heidi D.,
Geiger Ann M.,
Tooze Janet A.,
Kritchevsky Stephen B.,
Williamson Jeff D.,
Ellis Leslie R.,
Levitan Denise,
Pardee Timothy S.,
Isom Scott,
Powell Bayard L.
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03614.x
Subject(s) - medicine , geriatric depression scale , comorbidity , geriatrics , physical therapy , activities of daily living , depression (economics) , prospective cohort study , distress , observational study , gerontology , cognition , psychiatry , clinical psychology , depressive symptoms , economics , macroeconomics
Objectives To test the feasibility and utility of a bedside geriatric assessment ( GA ) to detect impairment in multiple geriatric domains in older adults initiating chemotherapy for acute myelogenous leukemia ( AML ). Design Prospective observational cohort study. Setting Single academic institution. Participants Individuals aged 60 and older with newly diagnosed AML and planned chemotherapy. Measurements Bedside GA was performed during inpatient exmination for AML . GA measures included the modified Mini‐Mental State Examination; Center for Epidemiologic Studies Depression Scale; Distress Thermometer, Pepper Assessment Tool for Disability (includes self‐ reported activities of daily living ( ADL s), instrumental ADL s, and mobility questions); Short Physical Performance Battery (includes timed 4‐m walk, chair stands, standing balance); grip strength, and Hematopoietic Cell Transplantation Comorbidity Index. Results Of 54 participants (mean age 70.8 ± 6.4) eligible for this analysis, 92.6% completed the entire GA battery (mean time 44.0 ± 14 minutes). The following impairments were detected: cognitive impairment, 31.5%; depression, 38.9%; distress, 53.7%; impairment in ADLs , 48.2%; impaired physical performance, 53.7%; and comorbidity, 46.3%. Most were impaired in one (92.6%) or more (63%) functional domains. For the 38 participants rated as having good performance status according to standard oncologic assessment (Eastern Cooperative Oncology Performance Scale score ≤1), impairments in individual GA measures ranged from 23.7% to 50%. Significant variability in cognitive, emotional, and physical status was detected even after stratification according to tumor biology (cytogenetic risk group classification). Conclusion Inpatient GA was feasible and added new information to standard oncology assessment, which may be important for stratifying therapeutic risk in older adults with AML .