While geriatric assessment (GA) is the gold standard for assessing frailty in older patients, it is often not implemented in general oncology practices due to time and resource constraints. Melissa Kah Poh Loh and her colleagues* investigated whether subjective age (how old one feels) — known to be associated with disability and mortality in older adults — can be used to identify patients with three or more impairments in geriatric assessment domains. Melissa reported her research at the 2017 SIOG meeting in Warsaw, Poland. The subjects included 349 patients aged 70 or more (mean age, 77) with a diagnosis of stage III or IV solid tumor or lymphoma and with at least one impaired domain on geriatric assessment. The most common cancers were gastrointestinal (30%), lung (24%), genitourinary (13%), and breast (11%). Overall, more than 56% of the patients felt younger than their actual age. About 36.4% felt the same age, and 7.5% felt older. Nearly 80% of the patients had impairments in at least 3 GA domains. But those who felt older than or the same as their chronological age were more likely to have GA impairments than those who felt younger than their actual age, specifically in physical performance, functional status, nutrition, and psychological health. Associations between subjective age and cognition, polypharmacy, and social support were not significant. Subjective age was associated with impairments in several GA domains and can thus be used to identify older patients who are frail or most likely to benefit from a complete GA in general oncology clinics or when enrolled in clinical trials. Future studies should evaluate the association of subjective age with outcomes from cancer treatment.
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*Melissa Kah Poh Loh, with P. Duberstein, L. Lei, H. Xu, E. Culakova, M. Wells, N. Gilmore, C. Pandya, J. Bautista, M. A. Flannery, S. G. Mohile (University of Rochester, New York, USA) and W. Dale (City of Hope, California, USA).
Melissa Kah Poh Loh is a Fellow in Hematology/Oncology at James Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA. She is a member of MASCC’s Study Groups on Fatigue, Geriatrics, and Psychosocial Issues.
