Markers and associations of nutrition identified in a senior adult oncology clinic.

Publication/Presentation Date

1-1-2023

Abstract

BACKGROUND:: The global population of adults is projected to increase dramatically in the coming years. Related to this change, researchers estimate that over two-thirds of all new cancers will occur in patients older than 65. It is imperative to understand the challenges our older patients have, and how they relate to cancer outcomes so that healthcare can adapt and support this population. We sought to evaluate how social determinants of health for older adults with cancer, including their comorbidities, frailty, poor nutrition, and lack of social support, are associated with cancer outcomes.

MATERIALS AND METHODS:: Patient demographics and clinical data were prospectively collected on an IRB-approved protocol for patients referred to a single NCI-designated cancer center’s multi-disciplinary Senior Adult Oncology Center. Comprehensive geriatric assessment was performed by geriatricians, pharmacists, medical and radiation oncologists, social workers, and dieticians. Median income, malnutrition, and frailty status were assessed. Logistic regression was used to investigate malnutrition and independent risk factors. Kaplan-Meier methods and Cox proportional hazards modeling were used to compare survival and investigate mortality and independent risk factors.

RESULTS:: From 2013–2016, 341 consecutive patients were evaluated. 49% were older than 80 and 51% were overweight or obese. Initial weight and BMI did not predict nutritional status. Per the mini nutritional assessment, most patients were “at risk” or “malnourished” (79%) and those patients were noted to have a median survival of 22 months compared to 52 months for those adequately nourished, relating a 2-fold higher covariate adjusted mortality risk (hazard ratio = 2.03; p< 0.01). Fit scale suggests 24% being frail, among whom experienced a median survival of 15 months compared to 36 months for those patients classified as fit or vulnerable, but was not statistically significantly associated with mortality after covariate adjustment (hazard ratio = 1.43; p=0.06).

DISCUSSIONS:: Nutritional and frailty status was associated with survival our older adult cancer patients. Efficiently screening patients and utilizing fitness and nutrition status determined by a multi-disciplinary team may be a reliable way to personalize care. Incorporating routine nutritional screening and designing interventions tailored to nutritional balance may improve outcomes in the older adult oncology population.

Volume

14

Issue

1

First Page

101388

Last Page

101388

ISSN

1879-4076

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

36253248

Department(s)

Administration and Leadership

Document Type

Article

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