Open AccessGeriatric Assessment‐Identified Deficits in Older Cancer Patients With Normal Performance Status
Author(s) -
Jolly Trevor A.,
Deal Allison M.,
Nyrop Kirsten A.,
Williams Grant R.,
Pergolotti Mackenzi,
Wood William A.,
Alston Shani M.,
Gordon BrittaneyBelle E.,
Dixon Samara A.,
Moore Susan G.,
Taylor W. Chris,
Messino Michael,
Muss Hyman B.
Publication year - 2015
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2014-0247
Subject(s) - medicine , polypharmacy , psychosocial , comorbidity , activities of daily living , breast cancer , cancer , logistic regression , geriatric oncology , physical therapy , gerontology , psychiatry
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.