Is “Geriatric” Assessment Just for Older Patients?

Aleixo, Gabriel F. P.; Choi, Seul Ki; Tan, Alyssa J.; Nyrop, Kirsten A.; Deal, Allison M.; Wood, William A.; Jolly, Trevor A.; Muss, Hyman B.

doi:10.1634/theoncologist.2019-0373

Cited by 12 publications

(6 citation statements)

References 10 publications

(15 reference statements)

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“…The logical and critical next step is to assess whether the higher risk can be mitigated by conducting interventions aimed at the detected aging‐related impairments. This is the premise of this study by Dr. Aleixo and colleagues .…”

mentioning

confidence: 61%

When It Comes to Geriatric Assessment, Rome Was Not Built in One Day

2020

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confidence: 61%

When It Comes to Geriatric Assessment, Rome Was Not Built in One Day

2020

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“…In a prior study, Aleixo et al 21 reported the prevalence of GA impairments among patients aged ,65 years with early-stage breast cancer. Patients aged 50 to 64 years had a high prevalence of falls in the past 6 months (15%), abnormal timed up-and-go test .14 seconds (12%), and impaired IADLs (17%).…”

Section: Discussionmentioning

confidence: 99%

“…Notably, another study among patients with early-stage breast cancer reported similar findings. 21 All patients who underwent GA evaluation did so at the time of initial contact with the UAB health system. Consequently, not all patients who presented for an initial appointment were previously untreated, and approximately 20% had already undergone cancer therapy at another facility.…”

Section: Discussionmentioning

confidence: 99%

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Association Between Chronologic Age and Geriatric Assessment–Identified Impairments: Findings From the CARE Registry

Giri

Al‐Obaidi

Weaver

et al. 2021

Journal of the National Comprehensive Cancer Network

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Background: The NCCN Guidelines for Older Adult Oncology recommend that, when possible, older adults with cancer undergo a geriatric assessment (GA) to provide a comprehensive health appraisal to guide interventions and appropriate treatment selection. However, the association of age with GA-identified impairments (GA impairments) remains understudied and the appropriate age cutoff for using the GA remains unknown. Patients and Methods: We designed a cross-sectional study using the Cancer and Aging Resilience Evaluation (CARE) registry of older adults with cancer. We included adults aged ≥60 years diagnosed with gastrointestinal malignancy who underwent a patient-reported GA prior to their initial consultation at the gastrointestinal oncology clinic. We noted the presence of GA impairments and frailty using Rockwood’s deficit accumulation approach. We studied the relation between chronologic age and GA impairments/frailty using Spearman rank correlation and chi-square tests of trend. Results: We identified 455 eligible older adults aged ≥60 years with gastrointestinal malignancies; the median age was 68 years (range, 64–74 years) and colorectal (33%) and pancreatic (24%) cancers were the most common cancer type. The correlation between chronologic age and number of geriatric impairments was weak and did not reach statistical significance (Spearman ρ, 0.07; P=.16). Furthermore, the prevalence of domain-specific impairments or frailty was comparable across the 3 age groups (60–64 years, 65–74 years, ≥75 years) with the exception of comorbidity burden. Notably, 61% of patients aged 60 to 64 years had ≥2 GA impairments and 35% had evidence of frailty, which was comparable to patients aged 65 to 74 years (66% and 36%, respectively) and ≥75 years (70% and 40%, respectively). Conclusions: Using chronologic age alone to identify which patients may benefit from GA is problematic. Future studies should identify screening tools that may identify patients at high risk of frailty and GA impairments.

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“… 18 , 19 We chose 60 years of age as criteria for enrollment in this registry given recognition of the uncertainty of the “right” age cutoff and to allow for meaningful age-related sub-analyses such as the current study. 20 For the current report, we included patients completing GA at the time of initial consultation to the UAB medical oncology clinic between 9/2017 and 10/2019. The Institutional Review Board of UAB (IRB-300000092) approved this study.…”

Section: Methodsmentioning

confidence: 99%

Use of Single-Item Self-Rated Health Measure to Identify Frailty and Geriatric Assessment-Identified Impairments Among Older Adults with Cancer

et al. 2022

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Background Poor self-rated health (SRH) is a known predictor of frailty and mortality in the general population; however, its role among older adults with cancer is unknown. We evaluated the role of SRH as a potential screening tool to identify frailty and geriatric assessment (GA)-identified impairments. Materials and Methods Adults ≥60 years diagnosed with cancer in the UAB Cancer & Aging Resilience Evaluation (CARE) registry underwent a GA at the time of initial consultation. We measured SRH using a single-item from the Patient-Reported Outcomes Measurement Information System global health scale and dichotomized responses as poor (poor, fair) and good (good, very good, and excellent). We evaluated the diagnostic performance of SRH in measuring frailty, and GA impairment (≥2 deficits among a set of seven GA domains). We examined the impact of SRH with survival using a Cox model adjusting for confounders, exploring the mediating role of frailty. Results Six hundred and three older adults with cancer were included, with a median age of 69 years. Overall, 45% (n = 274) reported poor SRH. Poor SRH demonstrated high sensitivity and specificity for identifying frailty (85% and 78%, respectively) and GA impairment (75% and 78%, respectively). In a Cox regression model, poor SRH was associated with inferior survival (HR = 2.26; 95% CI 1.60-3.18) after adjusting for confounders; frailty mediated 69% of this observed relationship. Conclusion Self-rated health may be used as a screening tool to identify older adults with cancer with frailty and GA impairments. Poor SRH is associated with inferior survival, which is mediated by frailty.

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Is “Geriatric” Assessment Just for Older Patients?

Cited by 12 publications

References 10 publications

When It Comes to Geriatric Assessment, Rome Was Not Built in One Day

When It Comes to Geriatric Assessment, Rome Was Not Built in One Day

Association Between Chronologic Age and Geriatric Assessment–Identified Impairments: Findings From the CARE Registry

Use of Single-Item Self-Rated Health Measure to Identify Frailty and Geriatric Assessment-Identified Impairments Among Older Adults with Cancer

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