Association of geriatric assessment factors with falls in older adults initiating chemotherapy.

Wildes, Tanya M.; Tew, William P.; Maggiore, Ronald J.; Edwards, Beatrice J.; Cohen, Harvey Jay; Smith, David; Mohile, Supriya G.; Owusu, Cynthia; Klepin, Heidi D.; Gross, Cary P.; Lichtman, Stuart M.; Gajra, Ajeet; Katheria, Vani; Akiba, Chie; Hurria, Arti

doi:10.1200/jco.2015.33.15_suppl.9542

Cited by 5 publications

(3 citation statements)

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“…Recovery from autologous HCT in myeloma is related to functional performance status either by objective measures such as the short physical performance battery or IADL. (66, 67) Autologous transplant is also indicated in patients with lymphoma. Sun et al retrospectively evaluated 170 patients with a median age of 72, 2-year PFS was -year 58% (95% [CI], 48%–67%) and overall survival was 65% (95% CI, 55%–74%).…”

Section: Frailty In Hematological Malignanciesmentioning

confidence: 99%

Frailty in Hematologic Malignancy

Koll

Rosko

2018

Curr Hematol Malig Rep

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Purpose of Review Older adults with hematologic malignancy are a growing demographic. Estimating risk of chemotherapy toxicity based on age alone, is an unreliable estimate of quality of life, functional capacity, or risk of treatment complications. Recent Findings Dedicated geriatric assessment tools can aid the clinician in identifying geriatric syndromes such as frailty, resulting in improved prognostication to decrease morbidity and mortality. Frailty is not synonymous with individual performance status and is dynamic. Summary Establishing the patient goals, values and preferences is central to the consideration of malignant hematology decision process. Careful considerations of available data on the patient’s prognosis based on estimated life expectancy, geriatric assessment data, and age-specific cancer mortality, with and without treatment, can reconcile the risks and benefits. Assessments of frailty, can aid the clinical feasibility and burden of the treatment to the patient and family in the context of each patient’s unique needs.

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Section: Frailty In Hematological Malignanciesmentioning

confidence: 99%

Frailty in Hematologic Malignancy

Koll

Rosko

2018

Curr Hematol Malig Rep

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“…There are multiple independent risk factors for falls. Irreversible risk factors include history of falls, frailty, impaired cognition, reduced performance status, and dependence in ADLs and instrumental ADLs (IADLs) . Potentially modifiable risk factors include medications, depression, hypotension and impaired vision, balance, and muscle strength .…”

Section: Introductionmentioning

confidence: 99%

“…Irreversible risk factors include history of falls, frailty, impaired cognition, reduced performance status, and dependence in ADLs and instrumental ADLs (IADLs). 3,5,7,11 Potentially modifiable risk factors include medications, depression, hypotension and impaired vision, balance, and muscle strength. 3 Falls risk-increasing drugs (FRIDs), comprising psychotropics and medications that cause orthostatic hypotension, are a potentially modifiable risk factor for falls.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with use of falls risk–increasing drugs among patients of a geriatric oncology outpatient clinic in Australia: a cross‐sectional study

Turner

Tervonen

Shakib

et al. 2016

Evaluation Clinical Practice

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Older people with cancer are at increased risk of falling. Falls risk-increasing drugs (FRIDs), comprising psychotropics and medications that cause orthostatic hypotension, are a potentially modifiable risk factor for falls. The objective of this study was to determine the prevalence and factors associated with use of FRIDs in older people with cancer. Patients aged ≥70 years who presented to a hospital outpatient clinic between January 2009 and July 2010 were included in the study. Information on current medication use, falls in previous 6 months, and frailty criteria was collected. Multinomial logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CIs) for factors associated with levels of FRID use. Overall, 76.1% (n = 293) of 383 patients used FRIDs. This comprised psychotropics (31.2%, n = 120) and medications causing orthostatic hypotension (69.9%, n = 269). In total, 24.0% (n = 92) patients reported falling in the previous 6 months. Risk factors for falling were associated with use of psychotropics but not orthostatic hypotension drugs. Patients with a history of falls had increased odds of using psychotropics (≥3 psychotropics; OR 13.50; 95%CI, 2.64-68.94). Likewise, frail patients had increased odds of using psychotropics (≥3 psychotropics; OR 27.78; 95%CI, 6.06-127.42). Risk factors for falling were associated with the use of psychotropics. This suggests that clinicians either do not recognize or underestimate the contribution of medications to falls in this high-risk patient group. Further efforts are needed to rationalize medication regimens at the time of patients' first presentation to outpatient oncology services.

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