title: A pilot study of the vulnerable elders survey-13 compared with the comprehensive geriatric assessment for identifying disability in older patients with prostate cancer who receive androgen ablation.
abstract: BACKGROUND
  Impairments in geriatric domains adversely affect health outcomes of the elderly. The Comprehensive Geriatric Assessment (CGA) is a key component of the treatment approach for older cancer patients, but it is time consuming. In this pilot study, the authors evaluated the validity of a brief, functionally based screening tool, the Vulnerable Elders Survey-13 (VES-13), for identifying older patients with prostate cancer (PCa) with impairment in the oncology clinic setting.
  
  
  METHODS
  Patients with PCa aged >or=70 years who actively were receiving androgen ablation treatment and who were followed within the clinics at the University of Chicago were eligible. Patients self-completed the VES-13 and CGA instruments and repeated the VES-13 1 month later. Physical performance and cognitive assessments were administered by a research assistant.
  
  
  RESULTS
  Of 50 participating patients, 50% were identified as impaired by the VES-13 (score >or=3). Sixty percent of patients scored as impaired on >or=2 tests within the CGA, exhibiting deficits in multiple domains. The reliability of the VES-13 (Pearson correlation coefficient) was 0.92. The cut-off score of 3 on the VES-13 had 72.7% sensitivity and 85.7% specificity for CGA deficits and was highly predictive for identifying impairment (area under the receiver operating characteristic curve, 0.90). Patients who had mean VES-13 scores >or=3 performed significantly worse on evaluations of activities of daily living (P = .001), physical performance (P = .002), comorbidity (P = .004), and cognitive impairment (P = .003).
  
  
  CONCLUSIONS
  Functional and cognitive impairments are highly prevalent among older patients with PCa who receive androgen ablation in oncology clinics. The current results indicated that the brief VES-13 performed nearly as well as a conventional CGA in detecting geriatric impairment in this population.
authors.affiliation: Department of Medicine (Oncology), Columbia Presbyterian Medical Center, New York, New York, USA.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bylow
authors.forename: William
authors.initials: W
authors.lastname: Dale
authors.forename: James
authors.initials: J
authors.lastname: Dignam
authors.forename: Kandis
authors.initials: K
authors.lastname: Martin
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Petrylak
authors.forename: Walter M
authors.initials: WM
authors.lastname: Stadler
authors.forename: Miriam
authors.initials: M
authors.lastname: Rodin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003071:Cognition; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000556:secondary; D011788:Quality of Life; D012372:ROC Curve; D012680:Sensitivity and Specificity; D035862:Vulnerable Populations / Q000706:statistics & numerical data*
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal