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Comparison of the Health and Functional Status Between Older Inpatients With and Without Cancer Admitted to a Geriatric/Internal Medicine Unit

Department of Internal Medicine and Geriatrics, Centre Hospitalo-Universitaire Sainte Marguerite, Marseille, France.

Please address correspondence to Frederique Retornaz, MD, Division of Geriatric Medicine, McGill University, Jewish General Hospital, 3755 Cote Sainte Catherine, Montreal, Quebec, H3T1E2, Canada. E-mail: frederique.retornaz{at}mail.mcgill.ca

Background. Cancer is predominantly a disease in the population aged 65 years and older. Previous studies have suggested that older cancers patients seen in oncology departments are healthy with few comorbidities. Relatively little is known about the health and functional status of older cancer inpatients, especially outside oncology units. The purpose of this study is to compare the health and functional status of older cancer and noncancer inpatients admitted to a geriatric/internal medicine unit.

Methods. A retrospective chart review was conducted on inpatients 65 years old and older, who had been hospitalized during a period of 2 years in the geriatric/internal medicine unit. The health and functional status of 144 inpatients with active cancer was compared to that of 682 inpatients without active cancer. Eight domains were compared: functional status, comorbidity, medication, nutritional status, neurosensory deficits, cognition, mood, and mobility. The hospitalization measures (length of stay, death, need for palliative care) were also compared.

Results. We found that inpatients with active cancer were younger, had less comorbidity and less cognitive impairment, but were more depressed and at greater risk for malnutrition than patients without cancer. These two groups were similar in terms of functional status, neurosensory deficit, and mobility. Cancer patients had a significantly shorter length of stay, required more palliative care, and were more likely to die during hospitalization.

Conclusion. These findings indicate that older cancer patients admitted to a geriatric/internal medicine unit present with multiple active geriatric problems, have characteristics distinct from those of traditional geriatric patients, and require specific care and management.

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