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Usefulness of Frailty Markers in the Assessment of the Health and Functional Status of Older Cancer Patients Referred for Chemotherapy: A Pilot Study

¹ Division of Geriatric Medicine, ² Solidage Research Group on Integrated Services for Older Persons, Centre for Clinical Epidemiology and Community Studies, and ³ Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

Address correspondence to Johanne Monette, MD, MSc, Division of Geriatric Medicine, Jewish General Hospital, 3755 Côte Sainte-Catherine, Montreal, Quebec, H3T1E2, Canada. E-mail: johanne.monette{at}mcgill.ca

Background. Older cancer patients seen in an oncology clinic seem to be healthier and less disabled than traditional geriatric patients. Choosing the most sensitive tools to assess their health status is a major issue. This cross-sectional study explores the usefulness of frailty markers in detecting vulnerability in older cancer patients.

Methods. The study included cancer patients 70 years old referred to an oncology clinic for chemotherapy. Information on comorbidities, disability in instrumental activities of daily living (IADL) and activities of daily living (ADL), and seven frailty markers (nutrition, mobility, strength, energy, physical activity, mood, and cognition) was collected. Patients were classified into four hierarchical groups: 1- No frailty markers, IADL, or ADL disability; 2- Presence of frailty markers without IADL or ADL disability; 3- IADL disability without ADL disability; 4- ADL disability.

Results. Among the 50 patients assessed, 6 (12.0%) were classified into Group 1, 21 (42.0%) into Group 2, 15 (30.0%) into Group 3, and 8 (16.0%) into Group 4. In Group 2, 7 patients (33.3 %) had one frailty marker, and 14 (66.7%) had two or more. The most prevalent of the frailty markers were nutrition, mobility, and physical activity.

Conclusion. The assessment of seven frailty markers allowed the detection of potential vulnerability among 42% of older cancer patients that would not have been detected through an assessment of IADL and ADL disability alone. A longitudinal study is needed to determine whether the use of frailty markers can better characterize the older cancer population and predict adverse outcomes due to cancer treatment.

Key Words: Cancer • Frailty markers • Elderly • Geriatric assessment • Functional status • Disability