Identifying Vulnerable Older Adults with Cancer: Integrating Geriatric Assessment into Oncology Practice
- 14 August 2007
- journal article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 55 (10), 1604-1608
- https://doi.org/10.1111/j.1532-5415.2007.01367.x
Abstract
To integrate the principles of geriatric assessment into the care of older patients with cancer in order to identify vulnerable older adults and develop interventions to optimize cancer treatment. A brief, comprehensive, self-administered questionnaire and intervention algorithm were developed consisting of measures of geriatric assessment that are brief, reliable, validated, and predictive of mortality and morbidity in older patients. Academic tertiary care cancer center and community-based satellite practice. Patients aged 65 and older with cancer. The questionnaire solicits information about the patient's functional status, comorbidity, psychological status, nutritional status, and social support. A scoring algorithm for referral to a multidisciplinary team was developed. Two hundred forty-five of 250 patients completed the questionnaire (mean age 76, range 65-95). The majority of patients were women (71%), white (95%), married (52%), and retired (90%), with a variety of tumor types and stages. Most patients (78%) completed the questionnaire on their own and reported acceptance of questionnaire length (91%), no difficult questions (94%), no upsetting questions (96%), and no missing questions (89%). The mean time to completion was 15 minutes, with a median of 12.5 (standard deviation 10, range 2-60). Information from this questionnaire helped identify physical and psychological impairments, poor nutrition, lack of social support, and untreated comorbidities. Appropriate referrals to a multidisciplinary team were made. This brief, comprehensive, self-administered questionnaire is feasible for use in the outpatient oncology setting and helped identify the needs of geriatric oncology patients. Prospective trials are needed to determine the effectiveness of the interventions offered.Keywords
This publication has 19 references indexed in Scilit:
- Is there age bias in the treatment of localized prostate carcinoma?Cancer, 2003
- Older age predicts a decline in adjuvant chemotherapy recommendations for patients with breast carcinomaCancer, 2003
- Age and Adjuvant Chemotherapy Use After Surgery for Stage III Colon CancerJNCI Journal of the National Cancer Institute, 2001
- Body Mass Index and Mortality Among Hospitalized PatientsArchives of Internal Medicine, 2000
- Comorbidity and functional status are independent in older cancer patients.Journal of Clinical Oncology, 1998
- The impact of age, marital status, and physician-patient interactions on the care of older women with breast carcinomaCancer, 1997
- Determinants of cancer therapy in elderly patientsCancer, 1993
- Value of functional status as a predictor of mortality: Results of a prospective studyAmerican Journal Of Medicine, 1992
- Predictors of Immediate and 6‐Month Outcomes in Hospitalized Elderly PatientsJournal of the American Geriatrics Society, 1988
- Prognostic effect of weight loss prior tochemotherapy in cancer patientsAmerican Journal Of Medicine, 1980