Development of a comprehensive geriatric assessment (CGA) measure for older patients (Pts) with cancer: A feasibility study

Abstract

8162 Background: As the cancer (CA) population ages, a brief, comprehensive measure is needed to help characterize the “functional age” of a patient (pt), in order to optimize treatment decisions and stratify outcomes based on factors other than chronological age. The purpose of this study was to develop a brief CGA for older pts with CA and to determine the feasibility of administering this assessment. Methods: The geriatrics and oncology literature were reviewed to choose validated measures commonly used in geriatric assessment across the following domains: functional status, comorbidity, cognition, psychological status, social functioning and support, and nutritional status. Criteria applied to measure selection included: reliability, validity, and brevity. The CGA was largely self-administered or administered by a trained research assistant if pts required assistance. Results: 43 pts (mean age 74.4; range 65–87) receiving chemo for breast CA, lung CA, colorectal CA, or lymphoma were enrolled. 68% had stage IV disease. Mean time to completion of CGA was 26.8 minutes (range 8.3 to 45 minutes). 78% were able to complete without assistance. 90% were satisfied with questionnaire length. 95% had comorbid medical conditions (mean 2.9; range 0–11). 38% were dependent in 1 or more instrumental activities of daily living, despite mean physician (MD) reported KPS of 81.8 (range 50–100). There was discordance (≥ 10 points) between MD and pt rated KPS 58% of the time, with pts more likely to report better KPS than MDs. Pts reported wide variability in physical functioning as described by the Medical Outcomes Study Physical Functioning Scale [mean score of 63 (Range 5–100; SD 30)]. One pt demonstrated gross cognitive impairment. 38% experienced >5% weight loss in the last 6 months. Neither age (p = 0.56) nor education (p = 0.99) were associated with ability to complete the questionnaires. Conclusions: This brief CGA can be largely self-administered and completed by the majority of pts without assistance. Prospective trials are needed to determine the ability of CGA to predict the extent of pts' toxicity to chemo, and disease specific or overall survival. No significant financial relationships to disclose.