The prevalence of geriatric problems in the Chilean patient with cancer

Abstract

Introduction: Chile shows a marked aging of the population and therefore in the future we will be faced with an increasing number of older adults with cancer. Unfortunately in our country is not very currently common the concept of the oncogeriatrics, and only exist two oncology centers in which is usually carried out a comprehensive assessment to the elderly patients. In this scenario to show the high prevalence of vulnerability in the Chilean elderly with cancer and demonstrate the usefulness of the CGA as diagnostic tool, is an essential first step to draw attention to Geriatrics and Oncology societies on a growing problem that involves them directly and eventually lead changes in the public health policies. Objectives: To determine the demographic and clinical characteristics of geriatric patients with cancer through Comprehensive Geriatric Assessment (CGA). Methods: Between July 2011 and May 2013, there was evaluated a random sample of patients of 65 years and older, with recently diagnosed cancer, previous to receive therapy and treated at Cancer Center of the Pontificia Universidad Catolica of Chile. A geriatrician applied the VGA (which included MMSE, MNA, Barthel, Lawton, Charlson, Geriatric depression scale (GDS)), plus Balducci and Rockwood fraiity score, and VES-13. Results: 130 patients patients entered the study. Age average 76 years (66-88).Considered frail 72%, 35% and 58% when assessed by criteria of Balducci, Rockwood and VES-13 respectively. On average, the number of new problems researched was 4 per patient, 52% required assistance with instrumental activities, 22% were dependent in ADL, 52% used inappropriate medications (according to Beers` criteria) 30% had cognitive impairment and 35% met the criteria for depression. 30 % hadmalnutrition. 10 % had an inadequate family support network. 22 % had three or more comorbidities. ECOGwas between 0 and 1 in 85 % of the patients. By comparing these values with a representative sample of Chilean people over 65 years living in the community, it is possible to observe the increased vulnerability of the patient with cancer (Table 1)