title: Impaired mobility, depressed mood, cognitive impairment and polypharmacy are independently associated with disability in older cancer outpatients: The prospective Physical Frailty in Elderly Cancer patients (PF-EC) cohort study.
abstract: OBJECTIVE
  To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer.
  
  
  METHODS
  The Physical Frailty in Elderly Cancer patients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted. Disability was defined as impairment in activities of daily living (ADL) and/or instrumental activities of daily living (IADL), simplified to four items. Univariate and multivariate logistic models of disabled patients were performed. The three final multivariate models were compared using the area under the receiver operating characteristic curve (AUC/ROC) of the logistic model.
  
  
  RESULTS
  The mean age was 80.6years, and 51% of the patients were women with various types of cancer. The prevalence of disability was 67.6%. No oncologic factors (cancer site, cancer extension) were associated with disability. Impaired mobility, poor functional status, depressive mood, cognitive impairment and polypharmacy were independently associated with disability (P<0.05). The AUC/ROC of the final models was similar.
  
  
  CONCLUSIONS
  Disability was highly prevalent in older cancer outpatients before cancer treatment but was not associated with oncologic factors. Impaired mobility, depressed mood, cognitive impairment and polypharmacy were the geriatric variables significantly and independently associated with disability. Identifying these factors prior to cancer treatment could enable the implementation of corrective actions to improve patient autonomy before treatment and during follow-up.
authors.affiliation: Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service de médecine gériatrique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France. Electronic address: frederic.pamoukdjian@aphp.fr.
authors.forename: Frederic
authors.initials: F
authors.lastname: Pamoukdjian
authors.affiliation: Service de Gastroentérologie et Cancérologie Digestive, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Aparicio
authors.affiliation: Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service d'oncologie médicale, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Zelek
authors.affiliation: Unité de Recherche Clinique et Centre de Recherche Clinique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
authors.forename: Marouane
authors.initials: M
authors.lastname: Boubaya
authors.affiliation: Département de gériatrie, unité d'oncologie gériatrique, hôpital Henri-Mondor, APHP, F94000 Créteil, France; Université Paris Est, A-TVB DHU, Clinical Epidemiology of Ageing (CEpiA) EA4393, F94010 Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Caillet
authors.affiliation: Service de court séjour gériatrique, hôpital René Muret, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93270 Sevran, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: François
authors.affiliation: Département de gériatrie, Hôpital Universitaire de Nantes, F44093 Nantes, France.
authors.forename: Laure
authors.initials: L
authors.lastname: de Decker
authors.affiliation: Unité de Recherche Clinique et Centre de Recherche Clinique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lévy
authors.affiliation: Unité de Coordination en Onco-Gériatrie, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France; Service de médecine gériatrique, hôpital Avicenne, Hôpitaux Universitaires de Paris Seine Saint Denis (HU PSSD, APHP), F93000 Bobigny, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Sebbane
authors.affiliation: Département de gériatrie, unité d'oncologie gériatrique, hôpital Henri-Mondor, APHP, F94000 Créteil, France; Université Paris Est, A-TVB DHU, Clinical Epidemiology of Ageing (CEpiA) EA4393, F94010 Créteil, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Paillaud
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000150:complications; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis / Q000453:epidemiology*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009369:Neoplasms / Q000523:psychology*; D019338:Polypharmacy; D011446:Prospective Studies; D012372:ROC Curve
keywords: Cognitive impairment; Comprehensive geriatric assessment; Depressed mood; Disability; Impaired mobility; Older cancer patients; Polypharmacy