Validation of a frailty index in older cancer patients with solid tumours

McCarthy, Alexandra; Peel, Nancye M.; Gillespie, Kerri; Berry, Robyn; Walpole, Euan; Yates, Patsy; Hubbard, Ruth E.

doi:10.1186/s12885-018-4807-6

Cited by 27 publications

(34 citation statements)

References 29 publications

(26 reference statements)

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“…Although our findings support the use of frailty screening in patients with newly diagnosed PDAC, these assessments are not widely used to determine treatment plans. McCarthy et al used a frailty index to predict chemotherapy outcomes in older patients with cancer. They found that patients who were not assigned treatment were significantly more frail than were patients who completed chemotherapy or ones who discontinued chemotherapy prematurely.…”

Section: Discussionmentioning

confidence: 99%

Association between frailty syndrome and survival in patients with pancreatic adenocarcinoma

et al. 2019

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Background Frailty is a syndrome characterized by weakness, slow gait, weight loss, exhaustion, and low activity. We sought to determine whether frailty was associated with age or stage in newly diagnosed patients with pancreatic ductal adenocarcinoma (PDAC), and determine its association with survival. Methods Consecutive patients with newly diagnosed PDAC of all stages underwent baseline assessment. Frailty (per Fried criteria) was defined as having three or more abnormalities in: grip strength, gait speed, weight loss, self‐reported exhaustion, or self‐reported physical activity. Baseline clinicodemographic characteristics, anatomic stage, performance status, and laboratory markers of prognosis were included. The association between baseline characteristics, frailty, and survival was determined. The associations of individual frailty measures with age, stage, comorbidities, and performance status were examined. Body composition was measured from computed tomographic images using SliceOMatic software. Results Of 150 patients enrolled, 8 were excluded because they did not have PDAC on final diagnosis. The median age was 65 years (range, 32‐89). Seventy‐nine patients (55.6%) were sarcopenic, and 36 (25.4%) were frail. Frailty was associated with increasing comorbidities (P = 0.03) and worse performance status (P < 0.01). During follow‐up, 79 patients (56%) died. Frailty was significantly associated with death during the follow‐up period (P < 0.001) for the entire cohort, including patients with curative (P = 0.038) and palliative (P = 0.003) treatment plans. Conclusions Frailty was seen frequently in patients with newly diagnosed PDAC and was not associated with increasing age or more advanced stage. Frailty was a predictor of survival, including patients treated with curative intent.

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Section: Discussionmentioning

confidence: 99%

Association between frailty syndrome and survival in patients with pancreatic adenocarcinoma

et al. 2019

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“…This can be explained by age-associated factors, such as frailty, and other biological and prognostic factors [3][4][5][6][7][8][9]. Frailty is a collective deterioration of multiple physical and physiological functions yielding a lower tolerance of stressors such as cancer and treatments [10].…”

Section: Introductionmentioning

confidence: 99%

A comparison of three different approaches to defining frailty in older patients with multiple myeloma

Isaacs

Fiala

Tuchman

et al. 2020

Journal of Geriatric Oncology

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a b s t r a c tObjectives: As the aging population grows, interest in applying the concept of frailty to older adults with cancer has increased. This study examines the prevalence of frailty in older patients with multiple myeloma using three frailty models. Methods: In this secondary analysis of a prospective cohort study, 40 adults aged ≥65 with myeloma completed the Cancer and Aging Research Group geriatric assessment within three months of initial diagnosis. Geriatric assessment data was used to categorize patients' frailty status according to three indices: The International Myeloma Working Group (IMWG) Frailty Index, the Revised Myeloma Comorbidity Index (R-MCI), and the Carolina Frailty Index (CFI). Agreement between the indices was examined using Cohen's kappa. Results: Twenty-eight patients were classified as frail by at least one of the models. However, only slight agreement exists on the classification of frailty among the indices, with little concordance among the models (Kappa 0.03-0.12). Only three patients were categorized as frail by all three models. Conclusion: In a cohort of 40 older adults with newly diagnosed multiple myeloma, three frailty indices have differing approaches to operationalizing frailty resulting, in different patients being categorized as frail. Little agreement existed between the models. Further studies are needed to explore the utility of these models in predicting treatment toxicity and prognosis.

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“…Another characteristic of frailty index is that each deficit should be health-related and increase with age. 24) Previous studies used 30-70 deficits to construct frailty indices. However, Searle et al 23) recommended that frailty indices should include at least 30-40 total deficits.…”

Section: Discussionmentioning

confidence: 99%

“…In general, missing variables can be imputed or removed from the denominator. 24 ) This study followed the latter approach of scoring KFI-PC. The KFI-PC score of each participant was calculated by dividing the number of deficits by the number of total variables that were recorded for that patient.…”

Section: Methodsmentioning

confidence: 99%

Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity

Won¹,

Lee²,

Lee³

et al. 2020

Ann Geriatr Med Res

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Background: The objective of this study was to develop and validate the Korean Frailty Index for Primary Care (KFI-PC) based on a comprehensive geriatric assessment. Methods: We developed a 54-item KFI-PC comprising 10 standard domains: cognitive status including delirium or dementia; mood; communication including vision, hearing, and speech; mobility; balance; bowel function; bladder function; ability to carry out activities of daily living; nutrition; and social resources. To test its validity, we applied KFI-PC to participants of the Korean Frailty Aging and Cohort Study (KFACS). We analyzed 1,242 participants (mean age, 77.9±3.9 years; 47.2% men) from the KFACS who visited 10 study centers in 2018, after excluding 32 participants with missing data required to assess Fried's physical frailty phenotype. Results: The mean KFI-PC score was 0.17±0.08, ranging from 0.02 to 0.52. The median KFI-PC score was higher in women than in men, and there was a trend toward higher values in older age groups. The prevalence of frailty when applying a generally used frailty index cutoff point of >0.25 was 17.5% in the whole study sample. As a construct validation of KFI-PC, the area under the receiver operating characteristic curve for Fried's physical frailty was 0.921, and the optimal cutoff value to predict frailty phenotype was 0.23. The KFI-PC score also correlated well with physical, cognitive, and psychological functions; nutritional status; disability in activities of daily living; and instrumental activities of daily living. The Cronbach's alpha coefficient of the 54 total items was 0.737. Conclusion: We developed KFI-PC with 53 deficits, including comprehensive geriatric assessment components, and demonstrated the acceptable construct validity and internal consistency of KFI-PC.

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Validation of a frailty index in older cancer patients with solid tumours

Cited by 27 publications

References 29 publications

Association between frailty syndrome and survival in patients with pancreatic adenocarcinoma

Association between frailty syndrome and survival in patients with pancreatic adenocarcinoma

A comparison of three different approaches to defining frailty in older patients with multiple myeloma

Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity

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