K. EL Haddad, Institut du Vieillissement, Gérontopôle, Université Toulouse III Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse, France. E-mail:
J Nutr Health Aging. 2020;24(2):147-151. doi: 10.1007/s12603-019-1293-8.
To examine frailty determinants differences in patients with a recent diagnosis of cancer compared to non-cancer patients among older adult. Revealing those differences will allow us to individualize the exact frailty management in those patients diagnosed with cancer.
This is an observational cross-sectional, monocentric study.
Patients were evaluated at the Geriatric Frailty Clinic (GFC), in the Toulouse University Hospital, France, between October 2011 and February 2016.
1996 patients aged 65 and older were included (1578 patients without cancer and 418 patients with solid and hematological cancer recently diagnosed).
Frailty was established according to the frailty phenotype. The frailty phenotype measures five components of frailty: weight loss, exhaustion, low physical activity, weakness and slow gait. Frailty phenotype was categorized as robust, pre-frail and frail.
In a multinomial logistic regression, cancer, compared to the non-cancer group, is not associated with an increased likelihood of being classified as pre frail (RRR 0.9, 95% CI [0.5 ; 1.6 ], p 0.9) or frail (RRR 1.2, 95% CI [0.7 ; 2.0], p 0.4) rather than robust. When considering each Fried criterion, a significant higher odd of weight loss was observed in older patients with cancer compared to the non-cancer patients (OR 2.3, 95% CI [1.8; 3.0], p <0.001) but no statistically significant differences was found among the four other Fried criteria. Sensitivity analysis on the frailty index showed that cancer was not associated with a higher FI score compared to non-cancer (β 0.002, 95%CI [-0.009; 0.01], p 0.6).
In this real-life study evaluating elderly patients with and without cancer, we didn't confirm our hypothesis, in fact we found that cancer was not associated with frailty severity using both a phenotypic model and a deficit accumulation approach. Cancer may contribute, at least additively, to the development of frailty, like any other comorbidity, rather than a global underlying condition of vulnerability.
比较老年癌症患者和非癌症患者的虚弱决定因素差异。揭示这些差异将使我们能够为诊断患有癌症的患者量身定制精确的虚弱管理。
这是一项观察性的横断面、单中心研究。
患者于 2011 年 10 月至 2016 年 2 月在法国图卢兹大学医院的老年虚弱诊所（GFC）进行评估。
共纳入 1996 名 65 岁及以上的患者（1578 名无癌症患者和 418 名近期诊断为实体瘤和血液系统癌症患者）。
根据虚弱表型确定虚弱。虚弱表型测量五个虚弱成分：体重减轻、乏力、低体力活动、虚弱和步态缓慢。虚弱表型分为健壮、虚弱前期和虚弱。
在多项逻辑回归中，与非癌症组相比，癌症与被归类为虚弱前期（RRR 0.9，95%CI [0.5；1.6]，p 0.9）或虚弱（RRR 1.2，95%CI [0.7；2.0]，p 0.4）的可能性增加无关。考虑到每个弗里德标准时，与非癌症患者相比，癌症老年患者体重减轻的可能性显著更高（OR 2.3，95%CI [1.8；3.0]，p<0.001），但其他四个弗里德标准之间没有统计学差异。虚弱指数的敏感性分析表明，与非癌症患者相比，癌症与更高的 FI 评分无关（β 0.002，95%CI [-0.009；0.01]，p 0.6）。
在这项评估有和无癌症的老年患者的真实生活研究中，我们没有证实我们的假设，事实上，我们发现，无论是使用表型模型还是缺陷积累方法，癌症与虚弱严重程度均无关联。癌症可能像任何其他合并症一样，至少是累加的，促进虚弱的发展，而不是一种潜在的脆弱整体状况。
