Defining an Abnormal Geriatric Assessment: Which Deficits Matter Most?

Cancers (Basel)

Department of Medicine, Toronto General Hospital, University Health Network, Toronto, ON M5G 2C4, Canada.

Published: December 2023

AI Article Synopsis

  • There’s no clear definition for what an abnormal geriatric assessment (GA) is in geriatric oncology, with different thresholds for abnormal domains leading to uncertainty about their impact on treatment plan modifications (TPM).
  • A study at Princess Margaret Cancer Centre analyzed a cohort of 736 older patients (average age of 80.7) to see how various GA domains correlated with TPM using logistic regression modeling.
  • The research found that an abnormal GA is best indicated by issues in cognition, comorbidities, and falls risk, with the most effective threshold for predicting TPM being 4 abnormal domains.

Article Abstract

At present, there is no clear definition of what constitutes an abnormal geriatric assessment (GA) in geriatric oncology. Various threshold numbers of abnormal GA domains are often used, but how well these are associated with treatment plan modification (TPM) and whether specific GA domains are more important in this context remains uncertain. A retrospective review of the geriatric oncology clinic database at Princess Margaret Cancer Centre in Toronto, Canada, including new patients seen for treatment decision making from May 2015 to June 2022, was conducted. Logistic regression modelling was performed to determine the association between various predictor variables (including the GA domains and numerical thresholds) and TPM. The study cohort (n = 736) had a mean age of 80.7 years, 46.1% was female, and 78.3% had a VES-13 score indicating vulnerability (≥3). In the univariable analysis, the best-performing threshold number of abnormal domains based on area under the curve (AUC) was 4 (AUC 0.628). The best-performing multivariable model (AUC 0.704) included cognition, comorbidities, and falls risk. In comparison, the multivariable model with the sole addition of the threshold of 4 had an AUC of 0.689. Overall, an abnormal GA may be best defined as one with abnormalities in the domains of cognition, comorbidities, and falls risk. The optimal numerical threshold to predict TPM is 4.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10742229PMC
http://dx.doi.org/10.3390/cancers15245776DOI Listing

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