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Dos Reis PF, Martucci RB. Factors influencing health-related quality of life in patients with bladder or kidney cancer: a prospective cohort study of the impact of nutritional status and frailty phenotype. J Cancer Surviv 2024:10.1007/s11764-024-01637-9. [PMID: 38954250 DOI: 10.1007/s11764-024-01637-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/21/2023] [Indexed: 07/04/2024]
Abstract
PURPOSE This study aimed to investigate the impact of nutritional status and frailty phenotype and the predictors of temporal changes on health-related quality of life (HRQoL) of patients with bladder or kidney cancer. METHODS Frailty phenotype, Patient-Generated Subjective Global Assessment, and Quality-of-life questionnaire Core-30 were applied twice to patients diagnosed with bladder or kidney cancer. Patients also completed a sociodemographic questionnaire, and clinical data were collected from records. RESULTS Sixty-two individuals completed the study, mostly male, with a mean age of 62.5 (± 11.4) years. The median time of follow-up was 14.5 months. Role functioning, emotional functioning, and fatigue improved over time (p < 0.05). The factors that negatively affected the long-term quality of life summary score were being female, malnourished, pre-frail and frail, cancer treatment, performance status, and lower income. Using the multivariate model, being malnourished (β = - 7.25; 95% CI, - 10.78 to - 3.71; p < 0.001), frail (β = - 7.25; 95% CI, - 13.39 to - 1.11; p = 0.021), and each one-point increase in performance status (β = - 6.9; 95% CI, - 9.54 to - 4.26; p < 0.001), were the ones that most negatively impacted the HRQoL between the two assessments. CONCLUSION This study confirmed that frailty, nutritional status, and performance status are the main predictors of HRQoL of patients with bladder or kidney cancer over time. IMPLICATIONS FOR CANCER SURVIVORS These findings may be the first step towards highlighting the importance of preventing malnutrition and frailty, in favor of a better long-term QoL for cancer patients.
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Affiliation(s)
- Patrícia Fonseca Dos Reis
- Education and Technical-Scientific Information Service, National Cancer Institute, Marquês de Pombal, 125, 3º andar, Centro, Rio de Janeiro, RJ, 20230-240, Brazil.
- Post-graduation Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Renata Brum Martucci
- Post-graduation Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Wang PP, Soh KL, Binti Khazaai H, Ning CY, Huang XL, Yu JX, Liao JL. Nutritional Assessment Tools for Patients with Cancer: A Narrative Review. Curr Med Sci 2024; 44:71-80. [PMID: 38289530 DOI: 10.1007/s11596-023-2808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/08/2023] [Indexed: 02/24/2024]
Abstract
Cancer patients are at high risk of malnutrition, which can lead to adverse health outcomes such as prolonged hospitalization, increased complications, and increased mortality. Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients. However, while many tools exist to assess malnutrition, there is no universally accepted standard. Although different tools have their own strengths and limitations, there is a lack of narrative reviews on nutritional assessment tools for cancer patients. To address this knowledge gap, we conducted a non-systematic literature search using PubMed, Embase, Web of Science, and the Cochrane Library from their inception until May 2023. A total of 90 studies met our selection criteria and were included in our narrative review. We evaluated the applications, strengths, and limitations of 4 commonly used nutritional assessment tools for cancer patients: the Subjective Global Assessment (SGA), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA), and Global Leadership Initiative on Malnutrition (GLIM). Our findings revealed that malnutrition was associated with adverse health outcomes. Each of these 4 tools has its applications, strengths, and limitations. Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients. It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.
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Affiliation(s)
- Peng-Peng Wang
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
- Nursing College of Guangxi Medical University, Nanning, 530021, China.
| | - Kim Lam Soh
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
| | - Huzwah Binti Khazaai
- Department of Biomedical Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Chuan-Yi Ning
- Nursing College of Guangxi Medical University, Nanning, 530021, China
| | - Xue-Ling Huang
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Jia-Xiang Yu
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Jin-Lian Liao
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
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Irie N, Muramoto N, Shirakawa T, China T, Kawano H, Isotani S, Horie S. High prevalence of frailty in patients with lower urinary tract symptoms. Geriatr Gerontol Int 2023; 23:609-615. [PMID: 37528501 DOI: 10.1111/ggi.14633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/31/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023]
Abstract
AIM Older adults are more likely to be frail and have a high prevalence of urological diseases such as lower urinary tract symptoms (LUTS). The purpose of this study was to clarify the prevalence and characteristics of comorbid frailty in older patients with urological diseases. METHODS We retrospectively reviewed the medical records of 970 patient who visited the Department of Urology, Juntendo University Hospital between October 2015 and October 2016. Patients were selected who were 65 years of age or older and were being evaluated by the Kihon Checklist (KCL) to assess frailty. We examined the prevalence of comorbid frailty in urological diseases, identified factors associated with comorbid frailty in urological diseases, and examined KCL scores in urological diseases with a high prevalence of frailty. RESULTS A total of 405 participants were included. Of these, 21.7% were frail, 20.5% were pre-frail, and 57.8% were robust. LUTS, overactive bladder, and neurogenic bladder showed a statistically significant relationship with comorbid frailty, with high frailty prevalence rates of 44/140 (31.4%), 19/36 (52.8%), and 4/6 (66.7%), respectively. Factors related to the comorbid frailty according to multivariate analysis were female sex (P = 0.001), older age (P < 0.001), and LUTS (P < 0.033). Of the KCL subscale scores, instrumental activities of daily living (P = 0.008), physical function (P < 0.001), oral function (P = 0.008), housebound (P = 0.009), and depression (P = 0.034) were higher in LUTS patients than in non-LUTS patients. CONCLUSIONS Among patients with urological diseases, those with LUTS were found to have a high prevalence of frailty. Geriatr Gerontol Int 2023; 23: 609-615.
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Affiliation(s)
- Naohiro Irie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Nobuhito Muramoto
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Tomoya Shirakawa
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Toshiyuki China
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Haruna Kawano
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
- Department of Advanced Informatics for Genetic Diseases, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Shuji Isotani
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
- Department of Advanced Informatics for Genetic Diseases, Juntendo University, Graduate School of Medicine, Tokyo, Japan
- Department of Digital Therapeutics, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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Wu HHL, Chinnadurai R, Walker RJ, Tennankore KK. Is It Time to Integrate Frailty Assessment in Onconephrology? Cancers (Basel) 2023; 15:cancers15061674. [PMID: 36980558 PMCID: PMC10046649 DOI: 10.3390/cancers15061674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
Simple Summary There are an increasing number of older people living with kidney cancer and/or cancer and kidney disease worldwide, sparking a wider discussion on the impact of frailty and the clinical significance of conducting frailty assessments for this patient population. We provide an update on the current evidence related to frailty assessment in onconephrology and identify areas where further research efforts are anticipated to address knowledge gaps within this topic. Abstract Onconephrology has emerged as a novel sub-specialty of nephrology dedicated to the intersection between the kidney and cancer. This intersection is broad and includes a number of important areas of focus, including concurrent chronic kidney disease (CKD) and cancer, acute kidney complications of cancer, and cancer-treatment-induced nephrotoxicity. The importance of onconephrology is even more evident when considering the global growth in the population of older adults, many of whom are living with some degree of frailty. Furthermore, a considerable proportion of older adults have CKD (some of whom eventually progress to kidney failure) and are at high risk of developing solid tumour and hematologic malignancies. Specific to kidney disease, the association between frailty status and kidney disease has been explored in depth, and tools to capture frailty can be used to guide the management and prognostication of older adults living with kidney failure. Whilst there is emerging data regarding the assessment and impact of frailty in onconephrology, there remains a relative paucity of knowledge within this topic. In this article, we evaluate the definition and operationalization of frailty and discuss the significance of frailty within onconephrology. We review evidence on current approaches to assessing frailty in onconephrology and discuss potential developments and future directions regarding the utilization of frailty in this patient population. A greater awareness of the intersections and interactions between frailty and onconephrology and further efforts to integrate frailty assessment in onconephrology to optimize the delivery of realistic and goal-directed management strategies for patients is needed.
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Affiliation(s)
- Henry H. L. Wu
- Renal Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, Sydney, NSW 2065, Australia
- Correspondence: ; Tel.: +61-9926-4751
| | - Rajkumar Chinnadurai
- Department of Renal Medicine, Northern Care Alliance NHS Foundation Trust, Salford M6 8HD, UK
| | - Robert J. Walker
- Department of Medicine, Dunedin Campus, University of Otago, Dunedin 9016, New Zealand
| | - Karthik K. Tennankore
- Department of Medicine, Dalhousie University and Nova Scotia Health, Halifax, NS B3H 4R2, Canada
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She Q, Chen B, Liu W, Li M, Zhao W, Wu J. Frailty Pathogenesis, Assessment, and Management in Older Adults With COVID-19. Front Med (Lausanne) 2021; 8:694367. [PMID: 34295914 PMCID: PMC8290059 DOI: 10.3389/fmed.2021.694367] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/14/2021] [Indexed: 12/11/2022] Open
Abstract
The 2019 coronavirus disease (COVID-19) is a highly contagious and deadly disease. The elderly people are often accompanied by chronic inflammation and immunodeficiency, showing a frail state. The strength, endurance, and physiological function of the elderly are significantly decreased, and the ability to deal with stress response is weakened. They are the high-risk group that suffering from COVID-19, and rapidly developing to critical illness. Several recent studies suggest that the incidence rate of COVID-19 in elderly patients with frailty is high. Early assessment, detection, and effective intervention of frailty in COVID-19 patients are conducive to significantly improve the quality of life and improve prognosis. However, there are insufficient understanding and standards for the current evaluation methods, pathogenesis and intervention measures for COVID-19 combined with frailty. This study reviews the progress of the research on the potential pathogenesis, evaluation methods and intervention measures of the elderly COVID-19 patients with frailty, which provides a reference for scientific and reasonable comprehensive diagnosis and treatment in clinical.
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Affiliation(s)
- Quan She
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Bo Chen
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Wen Liu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Min Li
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Weihong Zhao
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Jianqing Wu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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