Frailty Index and Frailty Phenotype in elderly patients with cancer

Deudekom, Floor J. van; Ruitenbeek, Marijke van de; Water, Wilma te; Smit, J. M.; Munster, Barbara C. Van

doi:10.3109/0284186x.2015.1096022

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Regarding the frailty index approach, much of the literature focuses on the comparison between the frailty index and the phenotype model in predicting risk of adverse outcomes [ 33 – 35 , 38 , 45 – 47 ]. Of note, it may be methodologically challenging to directly compare the continuous frailty index and the categorical phenotype model.…”

Section: Introductionmentioning

confidence: 99%

An overview of osteoporosis and frailty in the elderly

Thabane

Παπαϊωάννου

et al. 2017

BMC Musculoskelet Disord

154

126

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Osteoporosis and osteoporotic fractures remain significant public health challenges worldwide. Recently the concept of frailty in relation to osteoporosis in the elderly has been increasingly accepted, with emerging studies measuring frailty as a predictor of osteoporotic fractures. In this overview, we reviewed the relationship between frailty and osteoporosis, described the approaches to measuring the grades of frailty, and presented current studies and future research directions investigating osteoporosis and frailty in the elderly. It is concluded that measuring the grades of frailty in the elderly could assist in the assessment, management and decision-making for osteoporosis and osteoporotic fractures at a clinical research level and at a health care policy level.

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Section: Introductionmentioning

confidence: 99%

An overview of osteoporosis and frailty in the elderly

Thabane

Παπαϊωάννου

et al. 2017

BMC Musculoskelet Disord

154

126

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“…Frailty in older patients develops as result of advancing age and the presence of multiple comorbidities, combined with polypharmacy, which alters homeostasis and results in increased risk to stress and adverse effects such as falls and delirium. Generally, 10% of older persons aged ≥ 65 years are defined as frail, and this percentage raises to nearly half of all people > 85 years [11,38]. For example, gentamicin clearance was reduced in frail older patients compared to fit older patients [39].…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Model for Tramadol and O-desmethyltramadol in Older Patients

Al-Qurain

Upton

Tadros

et al. 2022

Eur J Drug Metab Pharmacokinet

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Background and ObjectivesTramadol is commonly prescribed to manage chronic pain in older patients. However, there is a gap in the literature describing the pharmacokinetic parameters for tramadol and its active metabolite (O-desmethyltramadol [ODT]) in this population. The objective of this study was to develop and evaluate a population pharmacokinetic model for tramadol and ODT in older patients. Methods Twenty-one patients who received an extended-release oral tramadol dose (25-100 mg) were recruited. Tramadol and ODT concentrations were determined using a validated liquid chromatography/tandem mass spectrometry method. A population pharmacokinetic model was developed using non-linear mixed-effects modelling. The performance of the model was assessed by visual predictive check. Results A two-compartment, first-order absorption model with linear elimination best described the tramadol concentration data. The absorption rate constant was 2.96/h (between-subject variability [BSV] 37.8%), apparent volume of distribution for the central compartment (V 1 /F) was 0.373 l (73.8%), apparent volume of distribution for the peripheral compartment (V 2 /F) was 0.379 l (97.4%), inter-compartmental clearance (Q) was 0.0426 l/h (2.19%) and apparent clearance (CL/F) was 0.00604 l/h (6.61%). The apparent rate of metabolism of tramadol to ODT (k t ) was 0.0492 l/h (78.5%) and apparent clearance for ODT (CL m ) was 0.143 l/h (21.6%). Identification of Seniors at Risk score (ISAR) and creatinine clearance (CrCL) were the only covariates included in the final model, where a higher value for the ISAR increased the maximum concentration (C max ) of tramadol and reduced the BSV in Q from 4.71 to 2.19%. A higher value of CrCL reduced tramadol C max and halflife (T 1/2 ) and reduced the BSV in V 2 /F (from 148 to 97.4%) and in CL/F (from 78.9 to 6.61%). Conclusion Exposure to tramadol increased with increased frailty and reduced CrCL. Prescribers should consider patients frailty status and CrCL to minimise the risk of tramadol toxicity in such cohort of patients.

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“…Many articles attempted to study different frailty screening or evaluation methods and their clinical relevance in the assessment of older patients with cancer (4,5). Furthermore, studies showed that frailty emerges in geriatric oncology as a predictor for an increased risk of chemotherapy intolerance, postoperative complications and mortality6 and was associated with negative outcomes such as an increase physical decline and poor functioning (5).…”

Section: Introductionmentioning

confidence: 99%