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.
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.
Mohile
Supriya G
SG
Department of Medicine (Oncology), Columbia Presbyterian Medical Center, New York, New York, USA.
Bylow
Kathryn
K
Dale
William
W
Dignam
James
J
Martin
Kandis
K
Petrylak
Daniel P
DP
Stadler
Walter M
WM
Rodin
Miriam
M
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*
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal