Frederic Pamoukdjian1, Thomas Aparicio2, Laurent Zelek3, Marouane Boubaya4, Philippe Caillet5, Veronique François6, Laure de Decker7, Vincent Lévy4, Georges Sebbane8, Elena Paillaud5. 1. Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service de médecine gériatrique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France. Electronic address: frederic.pamoukdjian@aphp.fr. 2. Service de Gastroentérologie et Cancérologie Digestive, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France. 3. Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service d'oncologie médicale, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France. 4. Unité de Recherche Clinique et Centre de Recherche Clinique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France. 5. Département de gériatrie, unité d'oncologie gériatrique, hôpital Henri-Mondor, APHP, F94000 Créteil, France; Université Paris Est, A-TVB DHU, Clinical Epidemiology of Ageing (CEpiA) EA4393, F94010 Créteil, France. 6. Service de court séjour gériatrique, hôpital René Muret, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93270 Sevran, France. 7. Département de gériatrie, Hôpital Universitaire de Nantes, F44093 Nantes, France. 8. Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service de médecine gériatrique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
Abstract
OBJECTIVE: To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer. MATERIALS AND METHODS: The Physical Frailty in Elderly Cancer patients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted. Disability was defined as impairment in activities of daily living (ADL) and/or instrumental activities of daily living (IADL), simplified to four items. Univariate and multivariate logistic models of disabled patients were performed. The three final multivariate models were compared using the area under the receiver operating characteristic curve (AUC/ROC) of the logistic model. RESULTS: The mean age was 80.6years, and 51% of the patients were women with various types of cancer. The prevalence of disability was 67.6%. No oncologic factors (cancer site, cancer extension) were associated with disability. Impaired mobility, poor functional status, depressive mood, cognitive impairment and polypharmacy were independently associated with disability (P<0.05). The AUC/ROC of the final models was similar. CONCLUSION: Disability was highly prevalent in older cancer outpatients before cancer treatment but was not associated with oncologic factors. Impaired mobility, depressed mood, cognitive impairment and polypharmacy were the geriatric variables significantly and independently associated with disability. Identifying these factors prior to cancer treatment could enable the implementation of corrective actions to improve patient autonomy before treatment and during follow-up.
OBJECTIVE: To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer. MATERIALS AND METHODS: The Physical Frailty in Elderly Cancerpatients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted. Disability was defined as impairment in activities of daily living (ADL) and/or instrumental activities of daily living (IADL), simplified to four items. Univariate and multivariate logistic models of disabled patients were performed. The three final multivariate models were compared using the area under the receiver operating characteristic curve (AUC/ROC) of the logistic model. RESULTS: The mean age was 80.6years, and 51% of the patients were women with various types of cancer. The prevalence of disability was 67.6%. No oncologic factors (cancer site, cancer extension) were associated with disability. Impaired mobility, poor functional status, depressive mood, cognitive impairment and polypharmacy were independently associated with disability (P<0.05). The AUC/ROC of the final models was similar. CONCLUSION: Disability was highly prevalent in older cancer outpatients before cancer treatment but was not associated with oncologic factors. Impaired mobility, depressed mood, cognitive impairment and polypharmacy were the geriatric variables significantly and independently associated with disability. Identifying these factors prior to cancer treatment could enable the implementation of corrective actions to improve patient autonomy before treatment and during follow-up.
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