Changes in functional status in older newly-diagnosed cancer patients during cancer treatment: A six-month follow-up period. Results of a prospective pilot study

Abstract

Objectives While the number of older cancer patients is expected to increase, little is known about their functional trajectories over time. A better understanding of those trajectories might allow to better select who will do well during treatment and to develop interventions to prevent/postpone functional decline. Materials and methods Newly-diagnosed cancer patients aged 65+ were recruited at the Jewish General Hospital, Montreal, Canada. Participants were interviewed at baseline, 3 and 6 month follow-up. At each interview, seven frailty markers (FM), functional limitations (FL), instrumental activities of daily living (IADL), basic activities of daily living (ADL) were assessed. Participants were grouped according to functioning: independent, only FM and/or FL, IADL disability, ADL disability and death. Changes in functional status were examined descriptively. Subsequently, logistic regression analyses were conducted to examine if deterioration in functioning (versus stable/improved) was associated with age, sex, diagnosis, extent of the disease, and treatment received (extensive versus not). Results There were 112 participants at baseline (response rate 72%), mean age of 74.2 years, and 70% were women. At baseline, 12 (10.7%) were independent, 59 (52.7%) had FM/FL, 39 (34.8%) had IADL disability, and 2 (1.8%) had ADL disability. Among the participants who completed the 6-month follow-up, 65 (61.9%) remained stable, 17 (16.2%) improved and 23 (21.9%) deteriorated in functioning. No variable was associated with deterioration in functioning in the multiple variable logistic regression analyses. Conclusions Twenty-two percent of participants experienced deterioration in their functional status. None of our variables was significantly associated with deterioration in functioning.