Risk factors for falls and fear of falling among older patients with cancer.

Abstract

e24032 Background: Cancer is a disease of the elderly with more than 60% of all cancers diagnosed in adults age 60 or older. Falls pose a substantial risk for older cancer patients leading to hip fractures, traumatic brain injury, and are the leading cause of injury-related hospitalizations in persons aged 60 and older. This risk is due to aging changes compounded by the effect of cancer and cancer therapy. This report aims at understanding risk factors for falls and the perception of fear of falling (FOF) among older patients with cancer. Methods: As a single-site, retrospective cohort study, data was derived from 249 geriatric oncology patients from Senior Adult Oncology Center at Jefferson Health. The primary endpoints are the number of falls in the preceding 12 months and FOF as part of a self-reported fall screening. Multivariate logistic regression model was used to identify the independent risks factors by including patients’ age, sex, race/ethnicity, BMI, polypharmacy, cancer types, ECOG scores, Timed up and go (TUG) test, CARG toxicity scores, Mini-Cog, frailty status and depressive symptom for each endpoint separately. Results: Majorities were White (62.1%) and female (57.2%) with a mean ages of 78.1 (SD = 8.7). The most common cancers diagnosed were hematologic malignancy (34.1%), gastrointestinal (23.4 %) and breast cancer (16.1%). 26.1% experienced one or more falls in the past 12 months and 28.9% were worried about falling. Average CARG score is 10.1 (SD = 3.8). 50.4% had an abnormal TUG tests and 23.6% had an abnormal Mini-Cog. In the multivariate logistic regression, CARG score (OR = 1.46 95% CI = 1.30 - 1.65, p = 0.000) was associated with falls in the past 12 months after adjusting for confounders. Further, both abnormal TUG (OR = 4.63 95% CI = 2.12-10.13 p = 0.000) and increased CARG score (OR = 1.17 95% CI = 1.05-1.31 p = 0.005) were associated with FOF. Conclusions: Falls and FOF are common among older cancer patients in our cohort. As the CARG toxicity score found as a major predictor for prior falls, our findings suggest the importance of future toxicity risk-tailored interventions which could potentially lead to the prevention of further falls. We also found that the TUG test and CARG were associated with FOF, which might diminish older cancer patient’s confidence in participating in daily activities. Future research is needed to investigate causal relationship among comprehensive risk factors and the efficacy of tailored interventions.