@article{3f843fa43db542c69281eea867c4017a,
title = "The Relationship Between Frailty and Emotional Health in Older Patients with Advanced Cancer",
abstract = "Background: Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to examine the relationship between frailty and emotional health in this population. Methods: This was a secondary analysis of baseline data from a nationwide cluster randomized trial. Patients were aged ≥70 years with incurable stage III/IV solid tumors or lymphomas, had ≥1 geriatric assessment (GA) domain impairment, and had completed the Geriatric Depression Scale, Generalized Anxiety Disorder-7, and Distress Thermometer. Frailty was assessed using a Deficit Accumulation Index (DAI; range 0–1) based on GA, which did not include emotional health variables (depression and anxiety), and participants were stratified into robust, prefrail, and frail categories. Multivariate logistic regression models examined the association of frailty with emotional health outcomes. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported. Results: Five hundred forty-one patients were included (mean age: 77 years; 70–96). DAI ranged from 0.04 to 0.94; 27% of patients were classified as robust, 42% prefrail, and 31% frail. Compared with robust patients, frail patients had an increased risk of screening positive for depression (aOR = 12.8; 95% CI = 6.1–27.0), anxiety (aOR = 6.6; 95% CI = 2.2–19.7), and emotional distress (aOR = 4.62; 95% CI = 2.9–8.3). Prefrail compared with robust patients also had an increased risk of screening positive for depression (aOR = 2.22; 95% CI = 1.0–4.8) and distress (aOR = 1.71; 95% CI = 1.0–2.8). Conclusion: In older patients with advanced cancer, frailty is associated with poorer emotional health, which indicates a need for an integrated care approach to treating these patients. Implications for Practice: A relationship exists between frailty and poor emotional health in older adults with advanced cancer. Identifying areas of frailty can prompt screening for emotional health and guide delivery of appropriate interventions. Alternatively, attention to emotional health may also improve frailty.",
keywords = "Anxiety, Depression, Distress, Emotional health, Frailty, Geriatric assessment",
author = "Nikesha Gilmore and Lee Kehoe and Jessica Bauer and Huiwen Xu and Bianca Hall and Megan Wells and Lianlian Lei and Eva Culakova and Marie Flannery and Grossman, {Valerie Aarne} and Sardari, {Ronak Amir} and Himal Subramanya and Sindhuja Kadambi and Elizabeth Belcher and Jared Kettinger and O'Rourke, {Mark A.} and Dib, {Elie G.} and Vogelzang, {Nicholas J.} and William Dale and Supriya Mohile",
note = "Funding Information: We thank Dr. Susan Rosenthal for her editorial assistance. We also thank all the SCOREboard members for their valuable contributions that resulted in the profound success of the COACH trial. This work was funded through a Patient-Centered Outcomes Research Institute (PCORI) Program contract (4634), the National Cancer Institute at the National Institutes of Health (R33 AG059206-01, UG1 CA189961, R01 CA177592, and K24 AG056589), and the University of Rochester CTSA award No. KL2TR001999. All statements in this report, including its findings and conclusions, are solely those of the authors, do not necessarily represent the official views of the funding agencies, and do not necessarily represent the views of the PCORI, its Board of Governors, or Methodology Committee. These data were presented at the Multinational Association of Supportive Care in Cancer Annual conference in 2019 as an oral presentation. Funding Information: We thank Dr. Susan Rosenthal for her editorial assistance. We also thank all the SCOREboard members for their valuable contributions that resulted in the profound success of the COACH trial. This work was funded through a Patient‐Centered Outcomes Research Institute (PCORI) Program contract (4634), the National Cancer Institute at the National Institutes of Health (R33 AG059206‐01, UG1 CA189961, R01 CA177592, and K24 AG056589), and the University of Rochester CTSA award No. KL2TR001999. All statements in this report, including its findings and conclusions, are solely those of the authors, do not necessarily represent the official views of the funding agencies, and do not necessarily represent the views of the PCORI, its Board of Governors, or Methodology Committee. These data were presented at the Multinational Association of Supportive Care in Cancer Annual conference in 2019 as an oral presentation. Publisher Copyright: {\textcopyright} 2021 AlphaMed Press.",
year = "2021",
month = dec,
doi = "10.1002/onco.13975",
language = "English (US)",
volume = "26",
pages = "e2181--e2191",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",
number = "12",
}