Geriatric Oncology

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Geriatric Assessment Predicts Falls, Functioning in Elderly Cancer Patients



Major Finding: ADL worsened in 17.2% of elderly cancer patients, and IADL in 38.9%, and 17.5% experienced at least one fall.

Data Source: Data are from a prospective, multicenter study of 811 elderly patients before and 2-3 months after cancer treatment.

Disclosures: The study was supported by Vlaamse Liga tegen Kanker. Ms. Kenis said she had no relevant financial disclosures.

MANCHESTER, ENGLAND – Undertaking a few simple baseline assessments in elderly patients may help predict their risk of worsening physical function and falls occurring 2-3 months into cancer therapy, a prospective, multicenter study has shown.

Nearly a fifth (17.2%) of 811 patients in the analysis experienced a worsening in Activities of Daily Living (ADL) during treatment. Instrumental Activities of Daily Living (IADL) scores decreased in 38.9%, and 17.5% had at least one fall.

Cindy Kenis, R.N.


"Parameters from the CGA [Comprehensive Geriatric Assessment] before treatment in older cancer patients can identify at-risk patients for decline in functionality and development of falls," Cindy Kenis, R.N., of the University Hospitals Leuven (Belgium), annual meeting of the International Society of Geriatric Oncology (SIOG).

This emphasizes the need to "make sure that we foresee the necessary support for older cancer patients based on the results of a geriatric screening and evaluation for the different geriatric problems detected," Ms. Kenis added later in an interview.

A total of 937 patients aged 70 years or older were included in the study. The median age was 76 years, and 63.5% of the study population were female. The most common malignancy was breast cancer (40.4%); other malignancies included colon cancer (20.6%), hematologic malignancies (15.9%), prostate cancer (9%), lung cancer (7.8%), and ovarian cancer (6.3%).

Several geriatric assessment tools were used at baseline, including the G8 and the Flemish Triage Risk Screening Tool (TRST), followed by a Comprehensive Geriatric Assessment (CGA).

Follow-up assessments after 2-3 months’ cancer treatment were ADL, IADL, the number of falls, and chemotherapy toxicity. A decline in functionality occurred if there was a worsening of ADL by 2 or more points and IADL by 1 or more points, or if the patient had a fall.

Worsening ADL could be predicted by baseline scores in three measures: IADL, a mininutritional assessment (MNA), and the Flemish TRST (all P less than .05).

Patients classified as "dependent" on IADL at baseline (a score less than 8 for women and less than 5 for men) were almost twice as likely to have worsening ADL at any time point during follow-up as were those not seen as dependent on IADL at baseline (odds ratio, 0.54).

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