A pilot study of the vulnerable elders survey‐13 compared with the comprehensive geriatric assessment for identifying disability in older patients with prostate cancer who receive androgen ablation

Abstract

BACKGROUND.Impairments in geriatric domains adversely affect health outcomes of the elderly. The Comprehensive Geriatric Assessment (CGA) is a key component of the treatment approach for older cancer patients, but it is time consuming. In this pilot study, the authors evaluated the validity of a brief, functionally based screening tool, the Vulnerable Elders Survey‐13 (VES‐13), for identifying older patients with prostate cancer (PCa) with impairment in the oncology clinic setting.METHODS.Patients with PCa aged ≥70 years who actively were receiving androgen ablation treatment and who were followed within the clinics at the University of Chicago were eligible. Patients self‐completed the VES‐13 and CGA instruments and repeated the VES‐13 1 month later. Physical performance and cognitive assessments were administered by a research assistant.RESULTS.Of 50 participating patients, 50% were identified as impaired by the VES‐13 (score ≥3). Sixty percent of patients scored as impaired on ≥2 tests within the CGA, exhibiting deficits in multiple domains. The reliability of the VES‐13 (Pearson correlation coefficient) was 0.92. The cut‐off score of 3 on the VES‐13 had 72.7% sensitivity and 85.7% specificity for CGA deficits and was highly predictive for identifying impairment (area under the receiver operating characteristic curve, 0.90). Patients who had mean VES‐13 scores ≥3 performed significantly worse on evaluations of activities of daily living (P = .001), physical performance (P = .002), comorbidity (P = .004), and cognitive impairment (P = .003).CONCLUSIONS.Functional and cognitive impairments are highly prevalent among older patients with PCa who receive androgen ablation in oncology clinics. The current results indicated that the brief VES‐13 performed nearly as well as a conventional CGA in detecting geriatric impairment in this population. Cancer 2007. © 2007 American Cancer Society.

Utility of the Edmonton Frail Scale in identifying frail elderly patients during treatment of colorectal cancer

“…In response to this, screening instruments have been developed. The Vulnerable Elder Survey (VES-13) did correlate with a CGA in a pilot study of 50 patients with metastatic prostate cancer, as well as more diverse population of hematological and solid malignancies (21,22). The G8 instrument has been developed by the ONCODAGE project in France, and there are comparative data against the VES-13 suggests better sensitivity (23).…”

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

“…Patients exhibiting deficiencies in one of the tests within each domain were defined as impaired in this domain. In accordance with previous research, patients exhibiting impairments in two or more domains within the CGA were defined as vulnerable (20,21). In addition, ECOG performance status (22) was recorded and diagnosis, initial treatment choice (full dose or reduced-dose chemotherapy) based on a multidisciplinary team decision, intolerance to treatment, death and cause of death were extracted from medical records.…”

Primeira etapa da adaptação transcultural do instrumento The Vulnerable Elders Survey (VES-13) para o Português

“…Por ser extensa e demorada, o rastreamento com um instrumento de fácil aplicação tem sido proposto para identificar aqueles que necessitariam de avaliação mais completa 2,3,4 . Esse é o objetivo do VES-13: rastrear os idosos vulneráveis, ou seja, aqueles com maior risco de declínio funcional e morte, para que sejam submetidos a uma avaliação mais ampla 1 .…”

“…É um instrumento simplificado, com tempo médio de aplicação de cinco minutos e constituído por 13 itens, que contemplam idade, saúde autorreferida, capacidade funcional e condição físi-ca 1 . Apresentou boa confiabilidade e validade em estudo com idosos com câncer de prósta-ta 2 , e tem sido utilizado como instrumento de rastreio em pacientes oncológicos 3,4 .…”