Associations among frailty and quality of life in older patients with cancer treated with chemotherapy. Issue 8 (November 2022)

• Record Type: Journal Article
• Authors: Crowder, Sylvia L.; Hoogland, Aasha I.; Small, Brent J.; Carpenter, Kristen M.; Fischer, Stacy M.; Li, Daneng; Kinney, Anita Y.; Welniak, Taylor L.; Brownstein, Naomi; Reich, Richard R.; Hembree, Tim; Extermann, Martine; Kim, Richard; Afiat, Thanh-Phuong; Berry, Donna L.; Turner, Kea; Jim, Heather S.L.
• Is Part Of: Journal of geriatric oncology. Volume 13:Issue 8(2022)
• Page Start: 1149
• Page End: 1155
• Publication Date: 2022-11
• Subjects: Aging -- Accumulated deficits -- Frailty -- Older patients -- cancer -- Quality of life; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2022.08.010
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Introduction: Previous studies have suggested that frailty among older adults with cancer is associated with a variety of negative outcomes, including greater chemotherapy toxicity and worse survival. However, results often do not include patient-reported outcomes, such as quality of life (QOL). The objective of this study was to evaluate frailty prior to receipt of moderately- or highly-emetogenic chemotherapy and acute changes in QOL in patients at least 65 years of age. It was hypothesized that frail patients would report greater declines in QOL. Materials and Methods: Participants completed questionnaires before receiving their first infusion and again five days later. A 59-item deficit accumulation index score was created at baseline using a modified Rockwood frailty index. QOL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G). The relationship between baseline frailty and QOL was evaluated using a dichotomized deficit accumulation index (frail vs. robust) in repeated measures ANOVA. Results: Study participants ( n = 151) had a mean age of 72 (SD = 4.5) and 62% were female. Nearly half (42%) were frail at baseline. Frail participants reported worse QOL at baseline compared to robust participants. Frail patients reported smaller declines in overall and physical ( p < 0.0001) and emotional ( p = 0.006) QOL from baseline to five days after receiving chemotherapy. At five days, frail participants reported better emotional and physical QOL compared to robust participants. Discussion: Contrary to expectations, frail patients reported smaller declines in QOL compared to robust patients using a deficit accumulation index. These results can be used to help educate frail patients on what to expect during treatment.