Identifying vulnerable older adults with cancer: Integrating geriatric assessment into oncology practice Journal Article


Authors: Hurria, A.; Lichtman, S. M.; Gardes, J.; Li, D.; Limaye, S.; Patil, S.; Zuckerman, E.; Tew, W.; Hamlin, P.; Abou-Alfa, G. K.; Lachs, M.; Kelly, E.
Article Title: Identifying vulnerable older adults with cancer: Integrating geriatric assessment into oncology practice
Abstract: OBJECTIVES: To integrate the principles of geriatric assessment into the care of older patients with cancer in order to identify vulnerable older adults and develop interventions to optimize cancer treatment. DESIGN: A brief, comprehensive, self-administered questionnaire and intervention algorithm were developed consisting of measures of geriatric assessment that are brief, reliable, validated, and predictive of mortality and morbidity in older patients. SETTING: Academic tertiary care cancer center and community-based satellite practice. PARTICIPANTS: Patients aged 65 and older with cancer. MEASUREMENTS: The questionnaire solicits information about the patient's functional status, comorbidity, psychological status, nutritional status, and social support. A scoring algorithm for referral to a multidisciplinary team was developed. RESULTS: Two hundred forty-five of 250 patients completed the questionnaire (mean age 76, range 65-95). The majority of patients were women (71%), white (95%), married (52%), and retired (90%), with a variety of tumor types and stages. Most patients (78%) completed the questionnaire on their own and reported acceptance of questionnaire length (91%), no difficult questions (94%), no upsetting questions (96%), and no missing questions (89%). The mean time to completion was 15 minutes, with a median of 12.5 (standard deviation 10, range 2-60). Information from this questionnaire helped identify physical and psychological impairments, poor nutrition, lack of social support, and untreated comorbidities. Appropriate referrals to a multidisciplinary team were made. CONCLUSION: This brief, comprehensive, self-administered questionnaire is feasible for use in the outpatient oncology setting and helped identify the needs of geriatric oncology patients. Prospective trials are needed to determine the effectiveness of the interventions offered. © 2007, The American Geriatrics Society.
Keywords: aged; aged, 80 and over; functional assessment; major clinical study; mortality; validation process; clinical practice; nutritional status; neoplasms; morbidity; psychology; oncology; cancer therapy; prediction; questionnaires; questionnaire; patient care; social support; algorithm; comorbidity; medical oncology; cancer care facilities; outpatient; reliability; tertiary health care; activities of daily living; geriatric assessment; nutrition; older cancer patient; self-administered
Journal Title: Journal of the American Geriatrics Society
Volume: 55
Issue: 10
ISSN: 0002-8614
Publisher: Wiley Blackwell  
Date Published: 2007-10-01
Start Page: 1604
End Page: 1608
Language: English
DOI: 10.1111/j.1532-5415.2007.01367.x
PUBMED: 17697101
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 30" - "Export Date: 17 November 2011" - "CODEN: JAGSA" - "Source: Scopus"
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MSK Authors
  1. Sujata Patil
    511 Patil
  2. Ghassan Abou-Alfa
    571 Abou-Alfa
  3. Arti Hurria
    36 Hurria
  4. Stuart Lichtman
    228 Lichtman
  5. Paul Hamlin
    291 Hamlin
  6. William P Tew
    247 Tew
  7. Eva Turowski Kelly
    4 Kelly