title: Geriatric assessment-identified deficits in older cancer patients with normal performance status.
abstract: BACKGROUND
  We investigated whether a brief geriatric assessment (GA) would identify important patient deficits that could affect treatment tolerance and care outcomes within a sample of older cancer patients rated as functionally normal (80%-100%) on the Karnofsky performance status (KPS) scale.
  
  
  METHODS
  Cancer patients aged ≥65 years were assessed using a brief GA that included both professionally and patient-scored KPS and measures of comorbidity, polypharmacy, cognition, function, nutrition, and psychosocial status. Data were analyzed using descriptive statistics and multivariable logistic regression.
  
  
  RESULTS
  The sample included 984 patients: mean age was 73 years (range: 65-99 years), 74% were female, and 89% were white. GA was conducted before (23%), during (41%), or after (36%) treatment. Overall, 54% had a breast cancer diagnosis (n = 528), and 46% (n = 456) had cancers at other sites. Moreover, 81% of participants (n = 796) had both professionally and self-rated KPS ≥80, defined as functionally normal, and those patients are the focus of analysis. In this subsample, 550 (69%) had at least 1 GA-identified deficit, 222 (28%) had 1 deficit, 140 (18%) had 2 deficits, and 188 (24%) had ≥3 deficits. Specifically, 43% reported taking ≥9 medications daily, 28% had decreased social activity, 25% had ≥4 comorbidities, 23% had ≥1 impairment in instrumental activities of daily living, 18% had a Timed Up and Go time ≥14 seconds, 18% had ≥5% unintentional weight loss, and 12% had a Mental Health Index score ≤76.
  
  
  CONCLUSIONS
  Within this sample of older cancer patients who were rated as functionally normal by KPS, GA identified important deficits that could affect treatment tolerance and outcomes.
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA trevor_jolly@med.unc.edu.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Jolly
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Nyrop
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Grant R
authors.initials: GR
authors.lastname: Williams
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Mackenzi
authors.initials: M
authors.lastname: Pergolotti
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Wood
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Shani M
authors.initials: SM
authors.lastname: Alston
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Brittaney-Belle E
authors.initials: BB
authors.lastname: Gordon
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Samara A
authors.initials: SA
authors.lastname: Dixon
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Moore
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: W Chris
authors.initials: WC
authors.lastname: Taylor
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Messino
authors.affiliation: Hematology and Oncology Division and Center for Aging and Health/Division of Geriatric Medicine, School of Medicine, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Rex Hematology Oncology Associates, Raleigh, North Carolina, USA; New Bern Cancer Care, New Bern, North Carolina, USA; Cancer Care of Western North Carolina (Affiliate of Mission Health), Asheville, North Carolina, USA.
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D012919:Social Behavior; D012944:Social Support
keywords: Cancer; Geriatric assessment; Older; Performance status