Frailty indicators and functional status in older patients after colorectal cancer surgery.
OBJECTIVE
The number of older survivors from colorectal cancer is increasing, but little is known regarding long-term consequences of cancer treatment in this patient group. Physical function is an important outcome for older patients, affecting both autonomy and quality of life. We aimed to investigate physical function in older patients with colorectal cancer before and after surgery, and to examine the role of individual frailty indicators as predictors of functional decline.


METHODS
We present 16-28 months follow-up data of older patients after elective surgery for colorectal cancer. During a home-visit, physical function was evaluated by activities of daily living (ADL), instrumental activities of daily living (IADL), the timed up-and-go (TUG) test, and grip strength. Measurements were compared with those obtained preoperatively using the Wilcoxon signed rank test. Frailty indicators were dichotomized and implemented in logistic regression models to explore their associations to a decline in the physical function scores.


RESULTS
Eighty-four patients were included and the median age was 82 years. There was a significant decrease in ADL (p = 0.04) and IADL scores (p ≤ 0.001) at follow-up. We found no associations between frailty indicators and the risk of decline in physical functioning.


CONCLUSIONS
In our population of older patients with surgically treated colorectal cancer, there was a significant decline in ADL- and IADL-scores at follow-up. No change was found in TUG or grip strength, and frailty indicators did not predict decline in physical function.
Department of Geriatric Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: benedroning@gmail.com.
Benedicte
B
Rønning
Department of Geriatric Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Torgeir Bruun
TB
Wyller
Department of Internal Medicine, Innlandet Hospital Trust Gjøvik, Gjøvik, Norway; Regional Center of Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway.
Marit Slaaen
MS
Jordhøy
Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway.
Arild
A
Nesbakken
Department of Digestive Surgery, Akershus University Hospital, University of Oslo, Lorenskog, Norway.
Arne
A
Bakka
Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.
Ingebjørg
I
Seljeflot
Department of Geriatric Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway; Diakonhjemmet Hospital, Department of Medicine, Diakonvn 12, 0319 Oslo, Norway.
Siri Rostoft
SR
Kristjansson
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D016330:Frail Elderly; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000503:physiopathology; D011300:Preoperative Care; D011446:Prospective Studies
Colorectal cancer; Frailty; Geriatric oncology; Geriatric surgery; Older cancer patients; Physical function