Citation

Zhang X, Sun M, Shah JB, Dinney CPN, Popat UR, Champlin RE, Valero V, Tripathy D, Hedberg AM, Edwards BJA. J. Clin. Oncol. 2017; 35(Suppl 5): e138.

Copyright

(Copyright © 2017, American Society of Clinical Oncology)

DOI

10.1200/JCO.2017.35.5_suppl.138

PMID

unavailable

Abstract

Conference Abstract #138
Background: More than 60% of cancer patients are older adults. Such patients undergo age and cancer therapy related changes. Older adults also have geriatric risk factors for falls such as frailty, cognitive impairment (mild cognitive impairment [MCI] and dementia), and malnutrition-including vitamin D deficiency.

OBJECTIVE: To assess the prevalence of vitamin D insuffiency and risk factors for falls in older cancer patients. Retrospective cohort study.

METHODS: Patients underwent prospective data collection and retrospective analysis. Patients underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, and comorbidity assessment. Vitamin D was assayed. Bone densitometry was performed. Analysis: Descriptive statistics, and multivariable logistic regression.

RESULTS: We enrolled 318 patients and 305 patients with complete data were included for final analysis. Patients were undergoing active cancer care. Patients had gastrointestinal, urologic, breast, lung and gynecologic cancers. The mean age was 78.4 ± 6.9 years. Low bone mass and osteoporosis were very common (80%) in this cohort. Twenty-six percent had one or more falls in the preceding six months. Dementia and mild cognitive impairment were seen in 33% and 37% of patients, and 53% presented frailty. In 256 patients, 48.8% (n = 125) had Vitamin D insufficiency ( < 30 ng/ml). In univariate analysis, co-morbidity (p = 0.05), frailty (p < 0.01), and cognitive impairment (0 = 0.02) were significantly associated with falls, while in multivariate analysis, frailty remained significantly associated with falls (OR = 3.51, 95%CI = 1.88, 6.52).

CONCLUSIONS: Older cancer patients have a high prevalence of falls, osteoporosis and vitamin D insufficiency, raising the possibility of injurious falls (fractures). Frailty was found to be the most prominent risk factor for falls in this cohort. Greater awareness and targeted interventions such as vitamin D replacement, physical therapy, nutrition interventions, and therapy for low bone mass/osteoporosis will be effective preventing injurious falls.

Language: en