1
|
Ramdany H, Lofaro T, Deplano S. The Haemato-Oncology Frailty (HOF) score to assess frailty in lymphoma. Eur J Haematol 2024; 112:611-620. [PMID: 38112247 DOI: 10.1111/ejh.14152] [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: 10/23/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]
Abstract
Morbidity and mortality during chemotherapy in older adults with haematological malignancy can be unpredictable. The Haemato-Oncology Frailty (HOF) score was previously found to predict outcomes in a cohort of patients with plasma cell myeloma. In this study, we assess its utility in assessing frailty in patients with lymphoma, and compare its performance to that of two other frailty scores. The HOF score was able to predict progression-free survival in this population, and was also shown to have potential in assessing the dynamism of frailty during chemotherapy. It performed well when compared to the Charlson Comorbidity Index (CCI) score and the Haematopoietic Cell Transplantation-Specific Comorbidity Index (HCTCI), although the study was not powered to assess for non-inferiority. The HOF score is a new score with the potential for application in different haematological malignancies.
Collapse
Affiliation(s)
- Hena Ramdany
- Imperial College London, Isle of Wight NHS Trust, Newport, UK
| | | | | |
Collapse
|
2
|
Jensen CE, Kuo TM, LeBlanc MR, Baggett CD, Duchesneau ED, Zhou X, Reeder-Hayes KE, Lund JL. Functional Status Associations With Treatment Receipt and Outcomes Among Older Adults Newly Diagnosed With Multiple Myeloma. JCO Clin Cancer Inform 2024; 8:e2300214. [PMID: 38320226 PMCID: PMC10861012 DOI: 10.1200/cci.23.00214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/05/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
PURPOSE Multiple myeloma (MM) is a prevalent hematologic malignancy in older adults, who often experience physical disability, increased health care usage, and reduced treatment tolerance. Home health (HH) services are frequently used by this group, but the relationship between disability, HH use, and MM treatment receipt is unclear. This study examines the connections between disability, treatment receipt, and survival outcomes in older adults with newly diagnosed MM using a nationwide data set. METHODS The SEER-Medicare data set was used to identify adults aged 66 years and older diagnosed with MM from 2010 to 2017, who used HH services the year before diagnosis. Disability was assessed with the Outcome and Assessment Information Set, using a composite score derived from items related to ability to complete activities of daily living. Mortality, therapy receipt, and health care utilization patterns were evaluated. RESULTS Of 37,280 older adults with MM, 6,850 (18.2%) used HH services before diagnosis. Moderate disability at HH assessment resulted in similar MM-directed therapy receipt as mild disability, with comparable health care usage after diagnosis to severe disability. HH users had a higher comorbidity burden and higher mortality (adjusted risk ratio for 3-year mortality: 1.59 [95% CI, 1.55 to 1.64]). Severe functional disability before diagnosis was strongly related to postdiagnosis mortality. CONCLUSION Among older adults with MM receiving HH services, disability is a predictor of early mortality. Moderately disabled individuals undergo similar therapy intensity as the mildly disabled but experience increased acute care utilization. Previous HH use could identify patients with MM requiring intensive support during therapy initiation.
Collapse
Affiliation(s)
| | - Tzy-Mey Kuo
- Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | | | - Christopher D. Baggett
- Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Emilie D. Duchesneau
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Xi Zhou
- Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Katherine E. Reeder-Hayes
- Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Division of Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Jennifer L. Lund
- Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| |
Collapse
|
3
|
Stevens E, Rosko AE, Huang Y, Funderburg A, Dvorak K, Von Ah D, Krok-Schoen JL. The association between religiosity, mental health, and cognitive functioning among older adults with hematologic malignancies. J Geriatr Oncol 2023:101446. [PMID: 36792415 DOI: 10.1016/j.jgo.2023.101446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/20/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Affiliation(s)
- Erin Stevens
- Department of Internal Medicine, Division of Palliative Medicine, The Ohio State University, Columbus, OH, United States of America; The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America.
| | - Ashley E Rosko
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, United States of America
| | - Ying Huang
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, United States of America
| | - Allesia Funderburg
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, United States of America
| | - Kaitlyn Dvorak
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, United States of America; Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, United States of America
| | - Diane Von Ah
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
| | - Jessica L Krok-Schoen
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America; Division of Health Sciences, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States of America
| |
Collapse
|
4
|
Demirel KD, Özkurt ZN, Doğrul RT, Kaynar LA, Yeğin ZA, Göker B, Yağci M. Is comprehensive geriatric testing guiding in the identification of multiple myeloma patients who are candidates for autologous stem cell transplantation? A prospective analysis. Ann Hematol 2022; 101:2691-2697. [PMID: 36195680 DOI: 10.1007/s00277-022-04992-8] [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: 05/15/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
Multiple myeloma (MM) is a hematological malignancy of older adults. This study aimed to investigate the differences in performance, comorbidity scores, and comprehensive geriatric assessment (CGA) before and after induction therapy in newly diagnosed MM patients, as well as the factors that may be associated with improved performance status after induction therapy. Thirty-seven consecutive patients aged 50 years and older, who were newly diagnosed with MM, were included in the study. The patients underwent performance status evaluation and CGA when first diagnosed and after 4 cycles of induction chemotherapy. The performance status of 11 patients (40.7%) changed after induction therapy. Improvement in performance status was significantly lower in patients who were frail according to the Fried frailty criteria and IMWG scores (60% vs. 25%, p = 0.04), (30.0% vs. 6.2%, p = 0.02), taking more than 2 medications due to comorbidities (p = 0.01, confidence interval 0.06-0.09) and those with renal involvement (80.0% vs. 18.7%, p = 0.002). Those with bone involvement were more prevalent among the patients whose performance status improved (87.5% and 50.0%, p = 0.03). This study demonstrated that performance status might improve after induction therapy. Results suggest that CGA before induction therapy can predict performance status change. These results might have implications for predicting at the time of diagnosis, whether an MM patient can be a transplant candidate after induction therapy.
Collapse
Affiliation(s)
- Kübra Durmuş Demirel
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Zübeyde Nur Özkurt
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Rana Tuna Doğrul
- Department of Geriatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Lale Aydin Kaynar
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Arzu Yeğin
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Berna Göker
- Department of Geriatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Münci Yağci
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
5
|
Fischer J, Knop S, Danhof S, Einsele H, Keller D, Löffler C. The influence of baseline characteristics, treatment and depression on health-related quality of life in patients with multiple myeloma: a prospective observational study. BMC Cancer 2022; 22:1032. [PMID: 36192719 PMCID: PMC9528097 DOI: 10.1186/s12885-022-10101-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/13/2022] [Indexed: 12/09/2022] Open
Abstract
Background Multiple myeloma (MM) is the third most common hematologic malignancy with increasing importance due to improving treatment strategies and long-term outcomes in an aging population. This study aims to analyse influencing factors on health-related quality of life (HRQoL), such as treatment strategies, participation in a clinical trial and patient characteristics like anxiety, depression, gender, and age. A better understanding of the individual factors in context with HRQoL could provide a helpful instrument for clinical decisions. Methods In this prospective observational study, the HRQoL of MM patients with different therapies (first-line and relapse) was quantified by standardized questionnaires (EORTC QLQ-C30 and -MY20) in the context of sociodemographic data, individual anxiety and depressiveness (PHQ-4), and a selected number of clinical parameters and symptoms at defined time-points before, during, and after therapy. Results In total, 70 patients were included in the study. The median age of the study cohort was 62 years. 44% were female and 56% were male patients. More than half of the patients were fully active with an ECOG 0. Global health status was significantly higher in patients with first-line treatment and even increased after start of therapy, while the pain level decreased. In contrast, patients with relapsed MM reported a decreasing global health status and increasing pain. Additionally, there was a higher global health status in less anxious/depressive patients. HRQoL decreased significantly after start of chemotherapy in the parameters body image, side effects of treatment, and cognitive functioning. Tandem stem-cell transplantation was not found to be a risk factor for higher impairment of HRQoL. Participation in a clinical study led to an improvement of most aspects of HRQoL. Among others, increased anxiety and depression, female gender, older age, impaired performance status, and recurrent disease can be early indicators for a reduced HRQoL. Conclusion This study showed the importance of regular longitudinal assessments of patient reported outcomes (PROs) in routine clinical care. For the first time, to our knowledge, we were able to demonstrate a potential impact between participation in clinical trials and HRQoL. However, due to frequently restrictive inclusion criteria for clinical trials, these MM patients might not be directly comparable with patients treated within standard therapy concepts. Further studies are needed to clarify the relevance of this preliminary data in order to develop an individualized, patient-centred, therapy concept. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10101-9.
Collapse
Affiliation(s)
- Julia Fischer
- Department of Pediatrics, Wuerzburg University Medical Center, Josef-Schneider-Straße 2, 97080, Würzburg, Germany.
| | - Stefan Knop
- Department of Haematology and Oncology, Wuerzburg University Medical Center, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Sophia Danhof
- Department of Haematology and Oncology, Wuerzburg University Medical Center, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Hermann Einsele
- Department of Haematology and Oncology, Wuerzburg University Medical Center, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Daniela Keller
- "Daniela Keller - Statistik und Beratung", Prosselsheimer Straße 4, 97273, Kuernach, Germany
| | - Claudia Löffler
- Department of Haematology and Oncology, Wuerzburg University Medical Center, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| |
Collapse
|
6
|
Yao Y, Sui WW, Liao AJ, Wang W, Chen LJ, Chu XX, Bao L, Cen XN, Fu R, Liu H, Sun CY, Jin FY, Yan H, Wang LQ, Yuan CL, Gao GX, Gao D, Zhang JQ, He JX, Hu JD, Ma LM, Zhang L, Zhou DB, Zou DH, Li J. Comprehensive geriatric assessment in newly diagnosed older myeloma patients: a multicentre, prospective, non-interventional study. Age Ageing 2022; 51:6399896. [PMID: 34673897 DOI: 10.1093/ageing/afab211] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/23/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Multiple myeloma is a disease of the older people, whose prognoses are highly heterogeneous. The International Myeloma Working Group (IMWG) proposed a geriatric assessment (GA) based on age, functional status and comorbidities to discriminate between fit and frail patients. Given the multidimensional nature of frailty and the relatively recent exploration of frailty in the field of MM, reaching a consensus on the measurement of frailty in MM patients remains challenging. OBJECTIVE We sought to assess the feasibility of performing a comprehensive GA (CGA) in older MM patients in a real-world and multicentre setting and to evaluate their baseline CGA profiles. RESULTS We studied 349 older patients with newly diagnosed MM (age range, 65-86 years). Our results showed that a CGA is feasible for older MM patients. Using the IMWG-GA criteria, we identified significantly more frail patients in our cohort comparing to in the IMWG cohort (43% vs 30%, P = 0.002). In the IMWG-GA 'fit' group, risk of malnutrition, depression and cognitive impairment remains. The median follow-up time was 26 months (range 1-38). The median overall survival (OS) was 34.7 months, and the estimated 3-year OS rate was 50%. A high MNA-SF score (MNA-SF ≥ 12), low GDS score (GDS ≤ 5) and high CCI score (CCI ≥ 2) can be used to predict the OS of older patients with newly diagnosed MM. This study is registered at www.clinicaltrials.gov (NCT03122327). CONCLUSIONS Our study justifies the need for a CGA in older patients with newly diagnosed MM.
Collapse
Affiliation(s)
- Yuan Yao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Wei-Wei Sui
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Ai-Jun Liao
- Department of Hematology, Shengjing Hospital of China Medical University
| | - Wei Wang
- Department of Hematology, The Affiliated Hospital of Qingdao University
| | - Li-Juan Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital
| | - Xiao-Xia Chu
- Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University
| | - Li Bao
- Department of Hematology, Beijing Jishuitan Hospital
| | - Xi-Nan Cen
- Department of Hematology, Peking University First Hospital
| | - Rong Fu
- Department of Hematology, Tianjin Medical University General Hospital
| | - Hui Liu
- Department of Hematology, Beijing Hospital, National Center of Gerontology
| | - Chun-Yan Sun
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Feng-Yan Jin
- Department of Hematology, Cancer Center, the First Hospital of Jilin University
| | - Hua Yan
- Department of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine
| | - Lu-Qun Wang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shangdong University
| | - Cheng-Lu Yuan
- Department of Hematology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University
| | - Guang-Xun Gao
- Department of Hematology, Xijing Hospital, Air Force Medical University
| | - Da Gao
- Department of Hematology, Inner Mongolia Medical College Affiliated Hospital
| | - Jin-Qiao Zhang
- Department of Hematology, Third Hospital of Hebei Medical University
| | - Jian-Xia He
- Department of Hematology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University
| | - Jian-Da Hu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology
| | | | - Lu Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - De-Hui Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| |
Collapse
|
7
|
Torstveit AH, Miaskowski C, Løyland B, Grov EK, Ritchie CS, Paul SM, Engh AME, Utne I. Characteristics associated with decrements in objective measures of physical function in older patients with cancer during chemotherapy. Support Care Cancer 2022; 30:10031-10041. [PMID: 36326906 PMCID: PMC9715479 DOI: 10.1007/s00520-022-07416-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Study purposes were to evaluate for inter-individual variability in the trajectories of three objective measures of physical function (PF) in older patients receiving chemotherapy (n = 112) and determine which characteristics were associated with worse PF. METHODS Balance, gait speed, and chair-stand test were evaluated at initiation and 1, 3, 6, 9, and 12 months following chemotherapy. Hierarchical linear modeling was used to assess inter-individual variability in the trajectories of the three tests. Demographic, clinical, and symptom characteristics, and levels of cognitive function associated with initial levels and changes over time in each of the tests were determined. RESULTS Gait speed and chair-stand tests improved over time. Balance declined until month 6, then increased. Characteristics associated with decreases in balance scores at initiation of chemotherapy were lower level of education and lower Karnofsky Performance Status (KPS) score. For initial levels of poorer gait speed, older age, poorer Trail Making Test B (TMTB), and worse Attentional Function Index scores were the associated characteristics. Lower KPS scores, higher body mass index, and poorer TMTB scores were associated with poorer chair-stand times at initiation of chemotherapy. Worse trajectories of chair-stand times were associated with poorer chair-stand time at enrollment. Characteristic associated with lower initial levels and improved trajectories of balance was older age at enrollment. CONCLUSIONS Determination of characteristics associated with decrements in balance, gait speed, and chair-stand can assist clinicians to identify older oncology patients at risk for decrements in PF. Interventions to maintain and improve PF need to be implemented with higher risk patients.
Collapse
Affiliation(s)
- Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | | | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | - Christine Seel Ritchie
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Mongan Institute Center for Aging and Serious Illness, Boston, MA USA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA USA
| | - Anna Marie Ellström Engh
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway ,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| |
Collapse
|
8
|
Hevroni G, Korde N. Examining health related quality of life outcomes in multiple myeloma: Past and future perspectives. Semin Oncol 2022; 49:94-102. [DOI: 10.1053/j.seminoncol.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/23/2021] [Accepted: 01/02/2022] [Indexed: 11/11/2022]
|
9
|
Torstveit AH, Miaskowski C, Løyland B, Grov EK, Guren MG, Ritchie CS, Paul SM, Kleven AG, Utne I. Common and distinct characteristics associated with self-reported functional status in older patients with cancer receiving chemotherapy. Eur J Oncol Nurs 2021; 54:102033. [PMID: 34537538 DOI: 10.1016/j.ejon.2021.102033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/04/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate for inter-individual differences in two subjective measures of functional status in older patients (n = 112), as well as to determine which demographic, clinical, and symptom characteristics, and levels of cognitive function, were associated with initial levels and with the trajectory of the two measures. METHODS Functional status was assessed using self-report measures of physical function (PF) and role function (RF) from the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess inter-individual differences in and characteristics associated with initial levels and changes in PF and RF. RESULTS Characteristics associated with decreases in PF at the initiation of chemotherapy were higher numbers of comorbidities and higher depression, pain, and dyspnea scores. For initial levels of poorer RF, lower Karnofsky Performance Status scores and higher pain and fatigue scores were the associated characteristics. Characteristic associated with worse trajectories of PF was not having had surgery. For RF, worse trajectories were associated with lower cognitive function and higher RF at enrollment. Characteristic associated with both lower initial levels and improved trajectories of PF was having lower performance status at enrollment. CONCLUSIONS Older patients undergoing chemotherapy experience reduced functional performance. Characteristics associated with decrements in PF and RF need to be assessed and interventions implemented to maintain and increase functional status in older oncology patients.
Collapse
Affiliation(s)
- Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Marianne Grønlie Guren
- Department of Oncology and K G Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
| | | | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Anne Grethe Kleven
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway.
| |
Collapse
|
10
|
Sgnaolin V, Sgnaolin V, Schneider RH. Implicações da avaliação geriátrica ampla na qualidade de vida em pessoas idosas com câncer: uma revisão integrativa. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.200297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Resumo A avaliação geriátrica ampla (AGA) melhora a qualidade do cuidado das pessoas idosas com câncer, pois permite a identificação de problemas geriátricos e fragilidades que tenham implicações na saúde do indivíduo. Apesar dos benefícios da AGA, dificuldades relacionadas ao tempo e gastos com essa ferramenta limitam sua implantação na prática. O objetivo desta revisão é avaliar a relação entre a AGA e a qualidade de vida (QV) de pessoas idosas com câncer, através de uma revisão integrativa da literatura. Foi realizada uma busca por artigos nas bases de dados PubMed, MEDLINE, IBECS e LILACS, publicados entre 2015 e 2020, que abordassem as implicações da AGA na QV de pessoas idosas com câncer e, dos 298 estudos encontrados, 21 foram selecionados para análise. Esses demonstraram que a AGA desempenha função importante ao identificar pessoas idosas com maior risco de comprometimento da QV durante a evolução da neoplasia e do tratamento oncológico, bem como ao orientar a indicação de intervenções geriátricas específicas que previnam a deterioração da QV. Assim, a presente revisão destaca a importância da avaliação integral das pessoas idosas com câncer que, através de diferentes âmbitos, sejam prognósticos ou intervencionistas, desenvolve um papel fundamental na preservação da QV dessa população. Compreende-se a necessidade de desenvolver estratégias para incorporação da AGA no cuidado das pessoas idosas com câncer.
Collapse
Affiliation(s)
- Valéria Sgnaolin
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brasil; Hospital Mãe de Deus, Brasil
| | - Vanessa Sgnaolin
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brasil
| | | |
Collapse
|