scholarly journals Sarcopenia Identification during Comprehensive Geriatric Assessment

2021 ◽  
Vol 19 (1) ◽  
pp. 32
Author(s):  
Krzysztof Pachołek ◽  
Małgorzata Sobieszczańska
Keyword(s):  
Muscle Strength ◽  
Functional Status ◽  
Muscle Mass ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Functional Independence ◽  
Adverse Outcomes ◽  
University Hospital ◽  
Diagnostic Process ◽  
Geriatric Syndrome

Comprehensive geriatric assessment (CGA) is a multidimensional diagnostic process enabling evaluation of elderly patients’ physical and mental health status that implies implementation of the management targeted on the preservation of functional independence. Sarcopenia is a common but often underdiagnosed geriatric syndrome associated with increased likelihood of functional dependence and mortality risk. The main objectives of the study were the evaluation of sarcopenia prevalence in the patient group subjected to CGA with the upgraded EWGSOP2 algorithm considering muscle strength as the key criterion and usage of bioimpedance (BIA) muscle mass assessment. The study group consisted of 101 patients (76 women and 25 men) admitted for planned CGA to the Geriatrics Department of Wroclaw University Hospital. A diagnosis of sarcopenia was made according to the EWGSOP2 protocol. Body composition was determined with the bioimpedance technique. Functional status was assessed with ADLs from the VES-13 scale and additional questions. Sarcopenia was diagnosed in 16.8% of the study participants. Sarcopenic individuals presented worse functional status and impaired social activity. Muscle strength, gait speed and muscle mass below cut-off values were associated with dependence found in ADLs. Results showed that sarcopenia is a common impairment correlated with worse functional status and vulnerability to adverse outcomes. BIA can be treated as an accessible and accurate technique for muscle mass measurement in screening for sarcopenia, and the EWGSOP2 algorithm should be an essential part of the routine CGA procedure.

Comprehensive Geriatric Assessment in elderly cancer outpatients in a university hospital. Differences in functional status

2008 ◽  
Vol 68 ◽  
pp. S32
Author(s):  
M.J. Molina-Garrido ◽  
C. Guillén-Ponce ◽  
M. Guirado-Risueño ◽  
M.J. Molina ◽  
M.A. Molina ◽  
...  
Keyword(s):  
Functional Status ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
University Hospital

scholarly journals THE BASICS OF COMPREHENSIVE GERIATRIC ASSESSMENT. HOMEORESIS AS A PREDICTOR OF FUNCTIONAL STATUS

2020 ◽  
Vol 4 (2) ◽  
pp. 41
Author(s):  
V. D. Sakevych ◽  
T. A. Trybrat ◽  
N. V. Liakhovska ◽  
V. I. Sakevych ◽  
I. V. Redchyts
Keyword(s):  
Functional Status ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment

scholarly journals Quantified Self and Comprehensive Geriatric Assessment: Older Adults Are Able to Evaluate Their Own Health and Functional Status

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100636 ◽  
Author(s):  
Olivier Beauchet ◽  
Cyrille P. Launay ◽  
Christine Merjagnan ◽  
Anastasiia Kabeshova ◽  
Cédric Annweiler
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Quantified Self

scholarly journals Muscle Mass and Muscle Strength Relationships to Balance: The Role of Age and Physical Activity

2020 ◽  
Vol 28 (2) ◽  
pp. 262-268 ◽  
Author(s):  
Élvio R. Gouveia ◽  
Andreas Ihle ◽  
Bruna R. Gouveia ◽  
Matthias Kliegel ◽  
Adilson Marques ◽  
...  
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Functional Independence ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
Old Adults ◽  
Simple Slope ◽  
Active Adults

Objective: To investigate the relations of balance to muscle mass (MM) and muscle strength (MS), depending on age and physical activity, which is of particular importance to functional independence in older people. Methods: This cross-sectional study included 802 volunteers (69.82 ± 5.60 years). The Fullerton Advanced Balance scale was used to assess balance and a composite score, including arm curl and chair stand tests for assessing MS. MM was estimated by dual-energy X-ray absorptiometry and physical activity by questionnaire. Results: Greater MM (r = .26, p < .001) and MS (r = .53, p < .001) were positively correlated to balance. The old-old adults and less active individuals attained lower balance. Notably, moderation and subsequent simple slope analyses revealed that the relations of balance, MM, and MS were larger in less active and the old-old adults. Conclusions: The old-old and less active adults were more prone to muscle weakness and balance impairments. Tailored interventions should particularly consider these vulnerable groups.

scholarly journals Comprehensive Geriatric Assessment in Elderly Patients with Aggressive Non-Hodgkin Lymphoma in Peru

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2307-2307
Author(s):  
Brady E. Beltrán ◽  
Rodrigo Motta ◽  
María P. Gamarra ◽  
Roger Araujo ◽  
Jorge J. Castillo
Keyword(s):  
Hodgkin Lymphoma ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Research Funding ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Geriatric Syndrome ◽  
Geriatric Syndromes ◽  
Cross Sectional ◽  
Non Hodgkin Lymphoma

Abstract Introduction: The incidence of Non-Hodgkin Lymphoma (NHL) is increasing, especially in people over 60 years of age. This population usually has a worse prognosis, probably due to comorbidities, functional deterioration and decreased tolerance to treatment. Therefore, a pre-therapeutic evaluation would be important to make decisions. The Comprehensive Geriatric Assessment (CGA) is the recommended tool for this evaluation, but it is a complex process that demands time and resources. We performed a study to evaluate the characteristics of the CGA in patients >64 years of age with NHL and to determine which domains can constitute a simplified model. Methods: This is a cross-sectional study with retrospective data collection of geriatric evaluations performed in >64 years with aggressive NHL (90% DLBCL, 10% PTCL) admitted to our institution between September 2015 and August 2017. Number of drugs, prescriptions in older adults was evaluated (STOPP), Lawton scale, Barthel scale, KATZ index, walking speed, Up and Go time (TUG), Mini-mental test, Yesavage scale, Gijón scale, Mini-nutritional, Geriatric syndromes (Incontinence, Falls, Pressure ulcers, Immobility, Sensory Deficits, Osteoporosis), and Accumulated Disease Scale in Geriatrics (CIRS-G). The CGA included 9 domains, and fragility was defined as deterioration in >2 domains. The different evaluations were compared with fragility. Multivariate models were constructed using logistic regression. Results: We included 253 patients with an average age of 76 years. 62% had >1 affected domain, and 40% were considered fragile (>2 affected domains). In the bivariate analysis, age >85 years, and all the geriatric scales except STOPP, were strongly associated with fragility. The final model had 6 variables: Use of >5 drugs ( OR 773.1, 95% CI,4.5-132134.4;p=0.011), Lawton scale <7 (OR 385.2,95%CI, 20.1-7363.5;p<0.001), TUG >20 (OR 124.6,95%CI, 6.2-2489.8;p=0.002), Mini-mental <23 (OR 53.5,95%CI, 3.7-778.8;p=0.004),Yesavage scale >5 (OR 118.7,95%CI, 11.2-1254.5;p<0.001), and presence of at least one geriatric syndrome (OR 235.6,95%CI, 13.3-4158.7;p<0.001). Removing the Mini-mental minimally affected the model, but suppressing two or more variables does weaken the model. Conclusions: In our cohort of patients older than 64 years with aggressive NHL, a model based on five measurements (i.e. number of drugs, TUG, Lawton scale, Yesavage scale and Geriatric Syndromes) could constitute an evaluation with an efficiency similar to a complete CGA. Disclosures Castillo: Pharmacyclics: Consultancy, Research Funding; Genentech: Consultancy; Millennium: Research Funding; Abbvie: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; Beigene: Consultancy, Research Funding.

scholarly journals Impact of the comprehensive geriatric assessment on treatment decision in geriatric oncology

2019 ◽  
Author(s):  
Sandrine Sourdet ◽  
Delphine Brechemier ◽  
Zara Steinmeyer ◽  
Stephane Gerard ◽  
Laurent Balardy
Keyword(s):  
Multivariate Analysis ◽  
Cancer Treatment ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Treatment Plan ◽  
Geriatric Oncology ◽  
Treatment Decision ◽  
Adverse Outcomes ◽  
Physical Performances ◽  
The Impact

Abstract Background The comprehensive geriatric assessment (CGA) is the gold standard in geriatric oncology to identify patients at high risk of adverse outcomes and optimize cancer and overall management. Many studies have demonstrated that CGA could modify oncologic treatment decision. However, there is little knowledge on which domains of the CGA are associated with this change. Moreover, the impact of frailty and physical performances on cancer treatment changes have been rarely assessed. Methods This is a cross-sectional study of older patients with solid or hematologic cancer referred by oncologists for a geriatric evaluation before cancer treatment. A comprehensive geriatric assessment was performed by a multidisciplinary team to decide if the initial cancer treatment plan was appropriate or not. We performed a multivariate analysis to identify CGA domains associated with the risk to judge the treatment inappropriate. Results 418 patients, mean age 82.8 ± 5.5, were included between 2011 and 2015. The initial cancer treatment plan was judged inappropriate in 56 patients (14.6%). In multivariate analysis, the treatment was judged inappropriate in patients with cognitive impairment (p=0.006), malnutrition (p=0.011), and low physical performances according to the Short Physical Performance Battery (p=0.001). Conclusion Cognition, malnutrition and low physical performances significantly affects cancer treatment decision in older adults with cancer. More studies are needed to evaluate their association with survival, treatment toxicity and quality of life. The role of physical performances should be specifically explored.

Comprehensive geriatric assessment and management for Canadian elders with Cancer: The 5C study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12011-12011
Author(s):  
Martine Puts ◽  
Naser Alqurini ◽  
Fay Strohschein ◽  
Johanne Monette ◽  
Doreen Wan-Chow-Wah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Data Collection ◽  
Cancer Treatment ◽  
Functional Status ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Primary Outcome ◽  
Group Performance

12011 Background: Comprehensive Geriatric Assessment (CGA) is recommended by ASCO for older adults with cancer undergoing chemotherapy to identify issues that can interfere with treatment delivery and optimize functional status and quality of life. However, few randomized controlled trials have been completed so far. Our objective is to evaluate the effectiveness of CGA on improving quality of life for older adults receiving cancer treatment. Methods: Eligible patients were aged 70+, diagnosed with a solid tumour, lymphoma or myeloma, referred for first/second line chemotherapy, speaking English/French, and with an Eastern Collaborative Oncology Group Performance Status 0–2. The CGA was done by a nurse and geriatrician followed by monthly phone calls by the study nurse for 6 months. Patients were randomly assigned (1:1) to receive either the intervention (CGA plus follow-up by geriatric trained team in addition to usual oncology care) or usual care alone. All participants received a monthly healthy aging booklet for attention control. Randomization was stratified by center and treatment intent (curative/adjuvant versus palliative). Our primary outcome was health-related quality of life (HRQOL) assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 global health scale (items 29 and 30). Secondary outcomes include functional status (Instrumental Activities of Daily Living). Outcome data collection was completed monthly for the first 6 months, then at 9 and 12 months. For the primary outcome we used a pattern mixture model using an intent-to-treat approach (at 0, 3, and 6 months). The last data collection took place March 8 2021. Results: From May 2017 to March 2020, 351 participants from 8 hospitals across Canada were enrolled. All patients were seen on or after day 1 of treatment for the intervention per patient request. Patient characteristics at baseline were similar in both arms. The average age was 75.7 (SD = 4.8), 60.4% was male and 54.3% had treatment with palliative intent. Change in HRQOL scores did not differ by arm (p =.80). Neither group exceeded the MCID of 10 points. There was also no difference in IADL between the groups (p = 0.82). Conclusion: CGA was not effective in improving quality of life for older adults receiving cancer treatment in this study. CGA may need to be performed prior to treatment initiation to achieve benefits. Clinical trial information: NCT03154671.

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