Geriatric Oncology Service, National Hospital Organization (NHO) Kyushu Cancer Center, Fukuoka, Japan.
Department of Gastrointestinal and Medical Oncology, National Hospital Organization (NHO) Kyushu Cancer Center, Fukuoka, Japan.
Oncologist. 2021 Oct;26(10):e1751-e1760. doi: 10.1002/onco.13894. Epub 2021 Jul 10.
A frailty index (FI) based on domain-level deficits identified through a comprehensive geriatric assessment (CGA) has been previously developed and validated in general geriatric patients. Our objectives were to construct an FI-CGA and to assess its construct validity in the geriatric oncology setting.
Five hundred forty consecutive Japanese patients with cancer who underwent a CGA on a geriatric oncology service were included (median age 80 years, range 66-96 years). We developed a 10-item frailty index based on deficits in 10 domains (FI-CGA-10): cognition, mood, communication, mobility, balance, nutrition, basic and instrumental activities of daily living, social support, and comorbidity. Deficits in each domain were scored as 0 (no problem), 0.5 (minor problem), and 1.0 (major problem). Scores were calculated by dividing the sum of the scores for each domain by 10 and then categorized as fit (<0.2), pre-frail (0.2-0.35), and frail (>0.35). Construct validity was tested by correlating the FI-CGA-10 with other established frailty measures.
FI-CGA-10 was well approximated by the gamma distribution. Overall, 20% of patients were fit, 41% were pre-frail, and 39% were frail. FI-CGA-10 was correlated with Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (r = 0.83), CSHA rules-based frailty definition (r = 0.67), and CSHA Function Score (r = 0.77). Increasing levels of frailty were significantly associated with functional and cognitive impairments, high comorbidity burden, poor self-rated health, and low estimated survival probabilities.
The FI-CGA-10 is a user-friendly and construct-validated measure for quantifying frailty from a CGA.
This article describes the construction of a user-friendly 10-item frailty index based on a comprehensive geriatric assessment (FI-CGA-10) for older adults with cancer: cognition, mood, communication, mobility, balance, nutrition, basic and instrumental activities of daily living, social support, and comorbidity. The FI-CGA-10 simplifies the original FI-CGA used in the general geriatric setting while maintaining its content validity. The index's construct validity was demonstrated in a cohort of older adults with various cancer types. The advantage of the FI-CGA-10 is that a frailty score can be calculated more readily and interpreted in a more clinically sensible manner than the original FI-CGA.
基于全面老年评估（CGA）中确定的领域缺陷的虚弱指数（FI）已在一般老年患者中得到开发和验证。我们的目的是构建 FI-CGA 并评估其在老年肿瘤学环境中的结构有效性。
540 名连续接受老年肿瘤学服务的日本癌症患者（中位年龄 80 岁，范围 66-96 岁）被纳入研究。我们根据 10 个领域（FI-CGA-10）的缺陷开发了一个 10 项虚弱指数：认知、情绪、沟通、移动、平衡、营养、基本和工具性日常生活活动、社会支持和合并症。每个领域的缺陷评分分别为 0（无问题）、0.5（轻度问题）和 1.0（重度问题）。得分通过将每个领域的得分相加再除以 10 计算得出，然后分为健康（<0.2）、虚弱前期（0.2-0.35）和虚弱（>0.35）。通过将 FI-CGA-10 与其他既定的虚弱指标相关联来测试结构有效性。
FI-CGA-10 很好地逼近了伽马分布。总体而言，20%的患者健康，41%的患者处于虚弱前期，39%的患者虚弱。FI-CGA-10 与加拿大健康与老龄化研究（CSHA）临床虚弱量表（r=0.83）、CSHA 基于规则的虚弱定义（r=0.67）和 CSHA 功能评分（r=0.77）相关。虚弱程度的增加与功能和认知障碍、高合并症负担、自我报告的健康状况差和低估计生存概率显著相关。
FI-CGA-10 是一种从 CGA 量化虚弱程度的用户友好且具有结构有效性的方法。
本文描述了一种用于老年癌症患者的基于全面老年评估的用户友好的 10 项虚弱指数（FI-CGA-10）的构建：认知、情绪、沟通、移动、平衡、营养、基本和工具性日常生活活动、社会支持和合并症。FI-CGA-10 简化了在一般老年患者中使用的原始 FI-CGA，同时保持其内容有效性。该指数的结构有效性在各种癌症类型的老年患者队列中得到了验证。FI-CGA-10 的优势在于，与原始 FI-CGA 相比，可以更轻松地计算虚弱评分并以更具临床意义的方式进行解释。
