A deficit-accumulation frailty index constructed from a comprehensive geriatric assessment may predict outcomes in older patients with cancer, according to a study published in the journal Cancer.1

Because frailty has been suggested as a domain for clinicians to consider when treating older patients with cancer, researchers sought to evaluate a frailty index from a mostly self-administered comprehensive geriatric assessment.

For the study, 500 patients age 65 years and older underwent the geriatric assessment prior to the receipt of chemotherapy. Investigators constructed the 51-item frailty index, and then examined cutoff values for patients in the robust/nonfrail (cutoff value, 0.0 to less than 0.2), prefrail (cutoff value, 0.2 to less than 0.35), and frail (cutoff value, 0.35 or greater) groups.

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Of those evaluated, 50% were considered were nonfrail, 39% were prefrail, and 11% were frail. Researchers found that older age (80 years or older), lower education, living alone, and higher stage of disease were associated with prefrail/frail status.

Results showed that prefrail/frail patients were more likely to experience grade 3 or worse toxicities but not to require dose interruption or reduction. They also had a higher likelihood of drug discontinuation and hospitalization.

“The frailty status so determined is associated both with outcomes likely because of chemotherapy toxicity and with those likely because of age-related physiologic and functional deficits and thus can be useful in the overall assessment of the patient,” the authors concluded.


1. Cohen HJ, Smith D, Sun CL, et al. Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy. Cancer. 2016 Aug 16. doi: 10.1002/cncr.30269. [Epub ahead of print]