A 10-Item Frailty Index Based on a Comprehensive Geriatric Assessment (FI-CGA-10) in Older Adults with Cancer: Development and Construct Validation

The oncologist

article

Tomohiro F. Nishijima¹  Mototsugu Shimokawa⁴  Taito Esaki²  Masaru Morita⁶  Yasushi Toh⁶  Hyman B. Muss³ 

[1] Geriatric Oncology Service, National Hospital Organization ,(NHO) Kyushu Cancer Center;Department of Gastrointestinal and Medical Oncology, National Hospital Organization ,(NHO) Kyushu Cancer Center;Department of Medicine, Division of Oncology, University of North Carolina at Chapel Hill;Cancer Biostatistics Laboratory, National Hospital Organization ,(NHO) Kyushu Cancer Center;Department of Biostatistics, Graduate School of Medicine, Yamaguchi University;Department of Gastroenterological Surgery, National Hospital Organization ,(NHO) Kyushu Cancer Center

关键词: Frailty;    Comprehensive geriatric assessment;    Construct validation;    Frailty index;    Older adults with cancer;   

DOI  :  10.1002/onco.13894

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background 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. Methods 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 (0.35). Construct validity was tested by correlating the FI-CGA-10 with other established frailty measures. Results 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. Conclusion The FI-CGA-10 is a user-friendly and construct-validated measure for quantifying frailty from a CGA. Implications for Practice 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.

【 授权许可】

CC BY|CC BY-NC