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Original Contribution Ability of the Comprehensive Geriatric Assessment to Predict Frailty in Older People Diagnosed with Cancer in a General Hospital Maria José Molina-Garrido 1 and Carmen Guillén-Ponce 2 1. Head, Senior Adult Oncology Consultation, Medical Oncology Department, Virgen de la Luz General Hospital, Cuenca; 2. Medical Oncologist, Oncology Department, Ramón y Cajal General Hospital, Madrid, Spain Abstract The field of oncogeriatrics considers the comprehensive geriatric assessment (CGA) as the main tool for distinguishing between patients who are frail and those who are not frail. The aim of our study was to determine the role of the CGA in predicting the risk of frailty in elderly patients. This prospective study was conducted at the Cancer in the Elderly Unit of the Medical Oncology Department at the Virgen de la Luz General Hospital in Cuenca, Spain. Demographic data and information about the CGA were collected. Using a bivariate logistic regression analysis, these factors were analysed and the factors that are associated with the risk of frailty were determined, as measured by the Barber questionnaire (BQ). We included 262 patients in the study with a mean age of 79 years (range 70–93 years). Seventy-four percent of the patients (n=194) had a risk of frailty as measured by the BQ. In the bivariate analysis, only age (odds ratio [OR] 1.064, 95 % confidence interval [CI] 1.000–1.133, p=0.051), being divorced, widowed or single (OR 0.450, 95 % CI 0.216–0.937, p=0.033) and being dependent in instrumental activities of daily living (IADL) (OR 3.003, 95 % CI 1.181–7.638, p=0.021) were associated with a higher risk of frailty. The risk of being frail in an elderly patient with cancer is higher in patients dependent in IADL and in patients who are not married. Age is another risk factor for frailty. Keywords Frailty, comprehensive geriatric assessment, Barber questionnaire, elderly patients with cancer Disclosure: The authors have no conflicts of interest to declare. Received: 1 December 2011 Accepted: 23 January 2012 Citation: European Oncology & Haematology, 2012;8(2):85–8 Correspondence: Maria José Molina-Garrido, Medical Oncology Department, Virgen de la Luz General Hospital, Calle Hermandad de Donantes de Sangre, 16002 Cuenca, Spain. E: mjmolinagarrido@hotmail.com Understanding frailty has become the focus of numerous investigations but, for the moment, there is no universally accepted definition. The concept of frailty has been developing over the past two decades. From the first article that referred to this term, published in 1953, 1 to the first article that referred to ‘frailty in the elderly’, published in 1991, 2 the number of publications using this term has increased tenfold. The phenotype best known and most widely publicised is that discussed by Fried et al. 3,4 In Spanish populations, the prevalence of frailty in the elderly ranges between 21.0 and 27.5 % in patients older than 65 years, 5 is 10 % among individuals aged between 70 and 79 years 6 and 46 % among those aged over 85 years. 7 However, these values depend heavily on the criteria used in the definition of frailty and the type of community studied. In the Women’s Health and Aging Study (WHAS), the prevalence was 11.3 % 8 and in the Cardiovascular Health Study (CHS), the prevalence was 11.6 %. 9 As the term ‘frailty’ is problematic, an operational definition of frailty has been used in this article based on the Barber questionnaire (BQ). This is the most widely used questionnaire for identifying risk to the elderly in the outpatient setting. 10,11 In general, it integrates, in a first-stage screening process, global strategies intended to more fully assess and intervene in selected elderly patients at risk, helping to prevent the occurrence of adverse events (mortality, hospitalisation or institutionalisation) in the short to medium term. 10–12 © TOUCH BRIEFINGS 2012 Our study’s aim was to determine which components of the comprehensive geriatric assessment (CGA), patient demographics and tumours predict which elderly patients diagnosed with cancer have a risk of frailty and which do not. It also seeked to develop a predictive model based on such characteristics and determine its predictive power. Materials and Methods Between March 2010 and October 2011, the Cancer in the Elderly Unit of the Medical Oncology Department at the Virgen de la Luz General Hospital in Cuenca, Spain, conducted a prospective study that included all patients over 70 years of age who had a diagnosis of cancer and who had been assessed at the unit. Patients signed a consent form to participate in this study. The study involved the systematic application of a specific model of the CGA and the application of the BQ, a test used routinely in our unit to assess the risk of frailty. The results from applying the questionnaire are variable. When considering the results of Spanish studies 13,14 and taking into account the original study by Barber, 10 the percentage of patients who complete the questionnaire is generally between 73 and 81 %. The sensitivity of the questionnaire to identify elderly patients at risk is approximately 94–95 %, the specificity is between 68 and 81 % and the positive predictive value (PPV) is between 91 and 94 %. 10,13,14 The CGA model used was specifically designed by the authors of this article and represents the first model created for the elderly Spanish 85