The Relationship Between Frailty and Emotional Health in Older Patients with Advanced Cancer

The purpose of this study was to test the mediating effects of coping on relationships of psychological distress and stress with anxiety, depression, and quality of life. A cross-sectional and correlational research study was used to recruit a sample of 440 patients with advanced cancer in Indonesia. A bootstrap resampling procedure was used to test the significance of the total and specific indirect effects of coping. Data analysis showed that problem-focused coping (PFC) mediated relationships of psychological distress and stress on depression, anxiety and functional well-being. PFC also mediated the relationship between stress and social well-being. Emotional-focused coping (EFC) mediated the relationship of stress with physical and emotional well-being. EFC also mediated the relationships between psychological distress and physical well-being. Thus, proper assessments and interventions should be tailored and implemented for patients in order to facilitate their use of coping strategies when needed in stressful situations.

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The relationship of adrenomedullin and left ventricular remodeling in older patients with essential hypertension

Heart ◽

10.1136/heartjnl-2011-300867.335 ◽

2011 ◽

Vol 97 (Suppl 3) ◽

pp. A113-A114

Author(s):

H. Jiang ◽

S. Peng

Keyword(s):

Essential Hypertension ◽

Older Patients ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Relationship Of ◽

The Relationship

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Older people's satisfaction with intermediate care: a systematic review

Reviews in Clinical Gerontology ◽

10.1017/s0959259808002475 ◽

2007 ◽

Vol 17 (3) ◽

pp. 199-218 ◽

Cited By ~ 3

Author(s):

Andrew Wilson ◽

Suzanne Richards ◽

Janette Camosso-Stefinovic

Keyword(s):

Systematic Review ◽

Older People ◽

Older Patients ◽

Hospital Care ◽

Patient Choice ◽

Intermediate Care ◽

Care Services ◽

The Relationship

Although intermediate care takes a variety of different forms and has developed somewhat differently in different countries, we believe that intermediate-care schemes have enough in common to make it meaningful to examine the relationship between this method of care and the views of older patients receiving either it or its alternatives. This is particularly important as one of the underlying principles of intermediate care is to extend patient choice; furthermore, most intermediate-care services target older people. In this review we examine evidence about whether older people prefer intermediate or hospital care, and what they like and dislike about intermediate care.

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Age affects the efficacy of immune checkpoint inhibitors in patients with advanced cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.2638 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 2638-2638

Author(s):

Yongjie Wang ◽

Ronghua Yang ◽

Dong Wang ◽

Donghua Zhao ◽

Peng Li ◽

...

Keyword(s):

Lung Cancer ◽

Advanced Cancer ◽

Immune Checkpoint ◽

Older Patients ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Sign Test ◽

Patients With Cancer ◽

The Impact ◽

Effect Of Age

2638 Background: Immune checkpoint inhibitors (ICIs), such as programmed death(ligand)1 (PD-(L)1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, have dramatic effects on treatment in patients with various malignancies. High tumor mutation burden (TMB) is predictive of clinical response to ICI in multiple cancer types. Although age-related immune dysfunction might induce difference on the efficacy of ICIs between younger and older patients, the potential effect of age on the efficacy of ICIs remains little known and controversial. Herein, we aimed to analysis the association between age and the efficacy of ICIs based on MSKCC cohort. Methods: We screened out 1661 patients having complete information with advanced cancer, whose tumors underwent next-generation sequencing (NGS) detection and who were treated with at least one dose of ICI in MSKCC cohort. All patients were divided into two groups according to age, the younger group (age ≤50-year old) and the older group (age > 50-year old). We further analyzed the differences in overall survival (OS) and TMB between the two groups. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated via Cox regression model for OS and P-values were calculated via the Wilcoxon sign test for TMB. We analyzed the effect of age on ICI in lung cancer using the same way. Results: In 1661 patients with cancer in our study, 312 (19%) younger and 1349 (81%) older patients were found. The pooled HRs for OS was 1.28 (95% CI: 1.09-1.52) in younger group compared with older group. In 1661 patients with cancer, there was 350 (21%) patients with lung cancer, including 30 (9%) younger and 320 (91%) older patients. The pooled HRs for OS was 1.45 (95% CI: 0.95-2.23) in younger group compared with older group in lung cancer. In addition, TMB in older group was higher than in younger group and significant difference of TMB was found via the Wilcoxon sign test (p = 2.6e-10) between the two groups, especially in lung cancer (p = 1e-4). Conclusions: Our study assessed the impact of age on the efficacy of ICIs using the threshold of 50 years old for the first time and we founded that patients in older group had higher TMB and longer OS than younger group.

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Prognostic understanding, hospitalization, and hospice use among older patients with advanced cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12037 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12037-12037

Author(s):

Kah Poh Loh ◽

Christopher Seplaki ◽

Reza Yousefi Nooraie ◽

Jennifer Leigh Lund ◽

Ronald M. Epstein ◽

...

Keyword(s):

Older Adults ◽

Advanced Cancer ◽

Generalized Estimating Equations ◽

Older Patients ◽

Cluster Randomized Trial ◽

Response Options ◽

Lower Odds ◽

Poor Understanding ◽

Cluster Randomized ◽

Hospice Use

12037 Background: Poor prognostic understanding of curability is associated with lower hospice use in patients with advanced cancer. Little is known if this holds true for older adults specifically. In addition, prognostic understanding are variably assessed and defined in prior studies. We evaluated the associations of poor prognostic understanding and patient-oncologist discordance in both curability and survival estimates with hospitalization and hospice use in older patients with advanced cancer. Methods: We utilized data from a national geriatric assessment cluster-randomized trial (URCC 13070: PI Mohile) that recruited 541 patients aged ≥70 with incurable solid tumor or lymphoma considering any line of cancer treatment and their oncologists. At enrollment, patients and oncologists were asked about their beliefs about cancer curability (options: 100%, > 50%, 50/50, < 50%, 0%, and uncertain) and estimates of patient’s survival (options: 0-6 months, 7-12 months, 1-2 years, 2-5 years, and > 5 years). Non-0% options were considered poor understanding of curability (uncertain was removed from the analysis) and > 5 years was considered poor understanding of survival estimates. Any difference in response options was considered discordant. We used generalized estimating equations to estimate adjusted odds ratios (AOR) assessing associations of poor prognostic understanding and discordance with hospitalization and hospice use at 6 months, adjusting for covariates and practice clusters. Results: Poor prognostic understanding of curability and survival estimates occurred in 59% (206/348) and 41% (205/496) of patients, respectively. Approximately 60% (202/336) and 72% (356/492) of patient-oncologist dyads were discordant in curability and survival estimates, respectively. In the first 6 months after enrollment, 24% were hospitalized and 15% utilized hospice. Poor prognostic understanding of survival estimates was associated with lower odds of hospice use (AOR 0.30, 95% CI 0.16-0.59) (Table). Discordance in survival estimates was associated with greater odds of hospitalization (AOR 1.64, 95% CI 1.01-2.66). Conclusions: Prognostic understanding may be associated with hospitalization or hospice use depending on how patients were queried about their prognosis and whether oncologists’ estimates were considered.[Table: see text]

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Blood Pressure Targets for Older Patients—Do Advanced Age and Frailty Really Not Matter?

Canadian Geriatrics Journal ◽

10.5770/cgj.23.429 ◽

2020 ◽

Vol 23 (2) ◽

pp. 205-209

Author(s):

Amanda Giffin ◽

Kenneth M. Madden ◽

David B. Hogan

Keyword(s):

Blood Pressure ◽

Risk Assessment ◽

Older Patients ◽

Intensive Therapy ◽

Advanced Age ◽

Blood Pressure Targets ◽

Prevention And Treatment ◽

Treatment Of Hypertension ◽

The Relationship

In 2017, Hypertension Canada removed advanced age and frailty as considerations for caution when deciding on intensive therapy in their guidelines for the diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Dementia is not mentioned. In this commentary, we review why advanced age and frailty were removed, and examine what is currently known about the relationship between hypertension and both incident and prevalent dementia. We make the case that the presence of frailty (especially when severe) and dementia should be considered when deciding on intensive therapy in future iterations of Hypertension Canada guidelines.

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