Patients over 65 years are assigned lower ECOG PS scores than younger patients, although objectively measured physical activity is no different.
OBJECTIVE
The Eastern Cooperative Group Performance Status (ECOG PS) is a widely used standard functional classification in oncology practice, the verbal descriptors of which refer to physical activity (PA). Little is known about the cut-off points of this scale and measured PA levels. This research investigated the relationship between PS assigned, objectively measured PA, and patient age.


METHODS
One hundred ambulatory patients with treatment-naive cancer wore an accelerometer (RT3) for a mean (SD) of 5.6 (1.1) days before initial oncology evaluation and ECOG PS assignment.


RESULTS
Seventy five participants (75%) were <65 years and 25 were ≥65 years. Eighty nine (89%) were assigned an ECOG PS of 0 or 1 and 11% a PS of 2 or 3. A weak but significant inverse association was found between objectively measured PA and PS (rho = -0.26, p = 0.01). Seventy one participants (80%) with a PS of 0 or 1 spent more than 50% of waking hours resting. Participants assigned a PS of 2-3 spent significantly more time resting than those assigned a PS of 0 (p = 0.01). Age ≥65 years was significantly related to PS assigned (p = 0.04), although the older cohort were no less sedentary than younger patients.


CONCLUSIONS
PA levels were low, but PS scoring reflected relative PA levels and differentiated between patients of PS 0 and 2-3. Chronological age was not predictive of activity levels, but older patients were assigned lower PS scores. Incorporation of objective PA measures may merit further investigation especially in the geriatric oncology setting.
School of Medicine, Trinity Centre for Health Science, St. James's Hospital, St. James's Street, Dublin 8, Ireland. Electronic address: julie.broderick@tcd.ie.
Julie M
JM
Broderick
School of Medicine, Trinity Centre for Health Science, St. James's Hospital, St. James's Street, Dublin 8, Ireland.
Juliette
J
Hussey
Department of Medical Oncology, St. James's Hospital, St. James's Street, Dublin 8, Ireland.
M J
MJ
Kennedy
Department of Medical Oncology, St. James's Hospital, St. James's Street, Dublin 8, Ireland.
Dearbhaile M
DM
O' Donnell
D061725:Accelerometry; D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015444:Exercise / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology*; D055815:Young Adult
Accelerometer; Eastern Co-operative Oncology Group; Geriatric assessment; Performance status; Physical activity