Maria Monica Gramatges, Baylor College of Medicine, Department of Pediatrics, Feigin Center, 1102 Bates St, Suite 1200, Houston, Texas, 77030, (p) 832-824-4678; (f) 832-825-4651,
J Frailty Aging. 2021;10(2):176-181. doi: 10.14283/jfa.2020.71.
Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which are scalable to large populations.
To validate a sensor-based frailty assessment tool in AYA CCS, compare frailty status between CCS and controls, and assess the correlation between frailty and number of CCS comorbidities.
DESIGN, SETTING, AND PARTICIPANTS: Mean frailty index (MFI) was assessed by a frailty wrist sensor in 32 AYA CCS who were ≥1 year off therapy and in remission. Results were compared with 32 AYA controls without cancer or chronic disease.
Frailty assessments with and without a simultaneous cognitive task were performed to obtain MFI. Results were compared between cases and controls using a Student t test, and the number of pre-frail/frail subjects by Chi Square test. The contribution of radiation therapy (RT) exposure to MFI was assessed in a sub-analysis, and the correlation between the number of comorbidities and MFI was measured using the Pearson method.
MFI was strongly correlated with gait speed in AYA CCS. CCS were more likely to be pre-frail than controls without cancer history (p=0.032), and CCS treated with RT were more likely to be pre-frail than CCS not treated with RT (p<0.001). The number of comorbidities was strongly correlated with MFI (ρ=0.65), with a 0.028 increase in MFI for each added condition (p<0.001).
Results from this study support higher risk for frailty among CCS, especially those with multiple comorbidities or who were treated with RT. A wrist-worn sensor-based method is feasible for application in AYA CCS, and provides an opportunity for cost-effective, rapid screening of at-risk AYA CCS who may benefit from early interventions.
儿童癌症幸存者（CCS）存在早老和虚弱的风险。CCS 的虚弱状况已通过既定的临床标准进行评估，这种方法需要专门的培训，耗时且费力。因此，需要一种经济有效的、快速的方法来评估高危青少年和年轻成人（AYA）CCS 的虚弱状况，这种方法需要适用于大量人群。
验证一种基于传感器的 AYA CCS 虚弱评估工具，比较 CCS 和对照组之间的虚弱状况，并评估虚弱与 CCS 合并症数量之间的相关性。
设计、地点和参与者：使用虚弱腕带传感器评估 32 名接受治疗 1 年以上且处于缓解期的 AYA CCS 的平均虚弱指数（MFI）。结果与 32 名无癌症或慢性疾病的 AYA 对照组进行比较。
进行了带有和不带有同步认知任务的虚弱评估，以获得 MFI。使用学生 t 检验比较病例组和对照组之间的结果，使用卡方检验比较有和无虚弱的受试者数量。在亚分析中评估了放射治疗（RT）暴露对 MFI 的影响，使用皮尔逊方法测量了合并症数量与 MFI 之间的相关性。
MFI 与 AYA CCS 的步态速度密切相关。CCS 比无癌症史的对照组更容易出现虚弱前期（p=0.032），接受 RT 治疗的 CCS 比未接受 RT 治疗的 CCS 更容易出现虚弱前期（p<0.001）。合并症的数量与 MFI 密切相关（ρ=0.65），每增加一种合并症，MFI 增加 0.028（p<0.001）。
本研究结果支持 CCS 中存在更高的虚弱风险，尤其是那些有多合并症或接受 RT 治疗的患者。腕部佩戴的基于传感器的方法适用于 AYA CCS，为经济有效地快速筛查可能受益于早期干预的高危 AYA CCS 提供了机会。
