Background: The benefits of Geriatric Assessment (GA) in older oncology patients are well recognised, however, currently GA is not routinely incorporated into cancer care services. Understanding of the prevalence of geriatric syndromes is required to inform requirements needed to facilitate integration of GA into available services. Identification of a predictive screening tool may facilitate targeting GA to those most likely to benefit.
Aims: Our primary aim was to describe the rates of geriatric syndromes in a tertiary hospital outpatient oncology population. Our secondary aim was to identify GA items predictive of poorer survival.
Methods: We prospectively collected data from consenting oncology outpatient clinic attendees aged 70 or older, including 13 GA tools and 12 month survival. The GA items were related to patient survival at 12 months using a cox proportional hazards model with elastic-net penalty, trained on these indices, to identify discriminative features predicting survival in this cohort. Predictor performance was assessed using time-course ROC curve analysis.
Results: 91 patients with a mean age of 75.6 participated in the study. Geriatric syndromes were frequent, in particular, polypharmacy (23.9%), dependence in at least one domain of instrumental activities of daily living (IADL) (27.2%), and malnutrition or at risk of malnutrition (15.2%). Lawton IADL score predicted survival best.
Conclusions: GA item deficits are common and represent an area for potential intervention to improve patient outcomes through MDT and geriatrician involvement. The Lawton IADL could represent an easy and quick stratification score to guide referral for GA and MDT interventions.