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Shabbir M H Alibhai, Salman Aziz, Tharsika Manokumar, Narhari Timilshina, Henriette Breunis
OBJECTIVE: Since the benefits of chemotherapy in treating older men with metastatic castration-resistant prostate cancer (mCRPC) are modest, validated tools that predict the risk of treatment toxicity may aid clinical decision-making. Whether these tools are better than oncologist judgment remains unclear. We compared the Cancer and Aging Research Group (CARG) tool, the Vulnerable Elders Survey-13 (VES-13), and oncologist judgment in predicting toxicity in men with mCRPC undergoing chemotherapy...
October 15, 2016: Journal of Geriatric Oncology
Lenore Beddoes-Ley, Damien Khaw, Maxine Duke, Mari Botti
BACKGROUND: There are limited published data reporting Australian hospitalized elders' vulnerability to functional decline to guide best practice interventions. The objectives of this study were to describe the prevalence of vulnerability to functional decline and explore profiles of vulnerability related to the performance of physical activity in a representative group of elders in a single centre in Victoria, Australia. METHODS: A cross-sectional survey of patients aged ≥ 70 years (Mean age 82...
2016: BMC Geriatrics
Lisa M Lowenstein, Supriya G Mohile, Heather Hopkins Gil, Chintan Pandya, Joshua Hemmerich, Miriam Rodin, William Dale
OBJECTIVES: Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elders Survey (VES-13) for mortality in older men with a PCa diagnosis as compared to controls. MATERIALS AND METHODS: Men aged ≥65years from an urban geriatrics clinic completed the VES-13 between 2003 and 2008...
July 29, 2016: Journal of Geriatric Oncology
Cynthia Owusu, Seunghee Margevicius, Mark Schluchter, Siran M Koroukian, Kathryn H Schmitz, Nathan A Berger
BACKGROUND: The purpose of this study was to determine the ability of the Vulnerable Elders Survey (VES-13) to predict the composite outcome of functional decline and death within 12 months of breast cancer treatment among women 65 years old or older with newly diagnosed stage I to III breast cancer. METHODS: Two hundred and six participants were recruited from ambulatory oncology clinics at an academic center between April 2008 and April 2013. Participants competed the VES-13 at baseline just before neoadjuvant/adjuvant treatment...
August 15, 2016: Cancer
Leopold Hentschel, Anke Rentsch, Felicitas Lenz, Beate Hornemann, Jochen Schmitt, Michael Baumann, Gerhard Ehninger, Markus Schuler
BACKGROUND: The aim of this study was to identify an appropriate screening instrument for the identification of frail elderly patients in a tertiary cancer center. In order to improve cancer care for older patients, the use of a geriatric assessment (GA) has been proposed to identify frail patients or those who are at a higher risk for chemotherapy-related toxicities. In busy clinical routine, an appropriate screening instrument could be used to spare time- and resource-consuming application of GA...
2016: Oncology Research and Treatment
Tharsika Manokumar, Salman Aziz, Henriette Breunis, S Faraz Rizvi, Anthony M Joshua, Ian F Tannock, Shabbir M H Alibhai
BACKGROUND: Treatment of metastatic castration-resistant prostate cancer (mCRPC) with chemotherapy improves disease control and survival in fit older men (age 65+) but its impact on function is not clear. We hypothesized that chemotherapy would impair daily function in older men with mCRPC. METHODS: Men aged 65+ with mCRPC starting chemotherapy or abiraterone were enrolled in this prospective observational pilot study. Daily function was evaluated with the OARS Instrumental Activities of Daily Living (IADL) scale...
March 2016: Journal of Geriatric Oncology
Giampaolo Ugolini, Francesco Pasini, Federico Ghignone, Davide Zattoni, Maria Letizia Bacchi Reggiani, Daniele Parlanti, Isacco Montroni
OBJECTIVE: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer (CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or under-treatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC...
December 2015: Cancer Biology & Medicine
Ariel R Green, Cynthia M Boyd, John Rickard, Robert Gomon, Bruce Leff
BACKGROUND: In elderly heart failure patients, the survival benefit of implantable cardioverter-defibrillators (ICDs) may be attenuated due to competing health risks, and the risk of adverse outcomes magnified. Our objective was to examine older adults' attitudes towards ICD implantation in the context of competing health risks, exploring the determinants of ICD decision-making among a group of patients who had faced the decision in the past. METHODS: Telephone survey with a qualitative component...
2015: BMC Geriatrics
Toru Okuyama, Koji Sugano, Shinsuke Iida, Takashi Ishida, Shigeru Kusumoto, Tatsuo Akechi
OBJECTIVES: To investigate the screening performance for frailty of the Vulnerable Elders Survey-13 (VES-13) and the 2-step approach consisting of the VES-13 plus the anhedonia (loss of interest or pleasure) item from Patient Health Questionnaire-9 (PHQ-9) among older patients with newly diagnosed cancer. METHODS: This study involved 106 consecutive inpatients aged 65 years or older, newly diagnosed with malignant lymphoma or multiple myeloma, just before chemotherapy initiation...
December 2015: Journal of the National Comprehensive Cancer Network: JNCCN
Cathy A Maxwell, Lorraine C Mion, Kaushik Mukherjee, Mary S Dietrich, Ann Minnick, Addison May, Richard S Miller
BACKGROUND: Injury is an external stressor that often initiates a cycle of decline in many older adults. The influence of physical frailty and cognitive decline on 6-month and 1-year outcomes after injury is unreported. We hypothesized that physical frailty and cognitive impairment would be predictive of 6-month and 1-year postinjury function and overall mortality. METHODS: The sample involved patients who are 65 years or older admitted to a Level I trauma center between October 2013 and March 2014 with a primary injury diagnosis...
February 2016: Journal of Trauma and Acute Care Surgery
Talal F Ali, Lindsey M Warkentin, Sayf Gazala, Adrian S Wagg, Raj S Padwal, Rachel G Khadaroo
OBJECTIVES: To examine health-related quality of life (HRQL) and cognitive and functional status before and after emergency surgical care in elderly adults. DESIGN: Six-month prospective cohort study. SETTING: Acute care and emergency surgery service at a single, academic tertiary care center, Edmonton, Alberta, Canada. PARTICIPANTS: Admitted individuals aged 65 and older (mean age 77.8 ± 7.9, 52% female) or their surrogates...
November 2015: Journal of the American Geriatrics Society
Lei Qin, Xuemei Luo, Kelly H Zou, Sonya J Snedecor
OBJECTIVES: To assess the costs of treating overactive bladder (OAB) with fesoterodine compared to no OAB pharmacotherapy among vulnerable elderly from the US payer perspective. METHODS: A decision analytic cost model was developed to estimate the 52-week costs of a cohort of vulnerable elderly with OAB initiating treatment with fesoterodine or no OAB pharmacotherapy. Vulnerable elderly OAB patients were defined as those aged ≥65 years with self-reported urge urinary incontinence (UUI) symptoms for ≥3 months, 2-15 UUI episodes/day, and at risk of deteriorating health by a score of ≥3 on the Vulnerable Elders Survey (VES)-13...
2016: Journal of Medical Economics
F Carneiro, N Sousa, L F Azevedo, D Saliba
BACKGROUND: "Vulnerable Elders Survey" (VES-13) is a questionnaire accurate in predicting functional decline and highly correlated with comprehensive geriatric assessment in identifying vulnerable elderly. The purpose of this study was to translate, cultural adapt and validate the first Portuguese cross-cultural version of VES-13 and to estimate the prevalence of vulnerability in Portuguese elderly gastrointestinal (GI) cancer patients. METHODS: VES-13 European Portuguese translation and cultural adaptation was developed according to internationally accepted guidelines...
2015: BMC Cancer
Susan P Bell, John Schnelle, Samuel K Nwosu, Jonathan Schildcrout, Kathryn Goggins, Courtney Cawthon, Amanda S Mixon, Eduard E Vasilevskis, Sunil Kripalani
OBJECTIVES: To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. PARTICIPANTS: Prospective observational cohort study of 445 individuals aged ≥ 65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decompensated heart failure. METHODS: Participants completed an inperson interview during hospitalisation, which included vulnerable functional status using the Vulnerable Elders Survey (VES-13), sociodemographic, healthcare utilisation practices and clinical patient-specific measures...
2015: BMJ Open
Jakub Kenig, Beata Zychiewicz, Urszula Olszewska, Marcin Barczynski, Wojciech Nowak
INTRODUCTION: The literature on geriatric assessment in emergency admitted patients is scarce, particularly there are no studies regarding the efficacy of frailty screening tests among patients qualified for emergency abdominal surgery. Therefore, the aim of this study was to compare the diagnostic accuracy of six screening instruments in this group of patients. MATERIAL AND METHODS: The diagnostic accuracy of the Vulnerable Elderly Survey (VES-13), Triage Risk Screening Tool (TRST), Geriatric-8 (G8), Groningen Frailty Index (GFI), Rockwood, Balducci score was evaluated in a prospective group of 184 consecutive patients ≥65 years of age...
November 2015: Archives of Gerontology and Geriatrics
Cathy A Maxwell, Mary S Dietrich, Ann F Minnick, Lorraine C Mion
OBJECTIVES: To determine the extent to which proxy respondents can provide reliable reports. DESIGN: Prospective cohort study. SETTING: Level I trauma center. PARTICIPANTS: Seventy-seven older adults (≥65, median 73.0, interquartile range 67-80; 53% female) admitted to three services (trauma, geriatrics, orthopedics) with primary injury diagnoses over a 6-month period and their proxies (43% spouses, 44% children, 5% siblings, 8% friends or other relatives)...
July 2015: Journal of the American Geriatrics Society
Gunter von Minckwitz, Bettina Conrad, Toralf Reimer, Thomas Decker, Holger Eidtmann, Wolfgang Eiermann, John Hackmann, Volker Möbus, Frederik Marmé, Jochem Potenberg, Elmar Stickeler, Eike Simon, Christoph Thomssen, Jens Huober, Carsten Denkert, Joachim Alfer, Christian Jackisch, Valentina Nekljudova, Nicole Burchardi, Sibylle Loibl
BACKGROUND: Although greater than 40% of breast cancers occur in patients aged ≥65 years, these individuals are frequently undertreated. Taxane-based adjuvant chemotherapy is considered the treatment of choice but to the authors' knowledge has only limited evidence in elderly patients. METHODS: Patients aged ≥65 years with a Charlson comorbidity index ≤2 and pT1/2 pN0/1 disease and either human epidermal growth factor receptor 2 (HER2)-positive, hormone receptor-negative, grade 3 (according to Common Terminology Criteria for Adverse Events [version 3...
October 15, 2015: Cancer
Andrea Luciani, Laura Biganzoli, Giuseppe Colloca, Cristina Falci, Bruno Castagneto, Irene Floriani, Nicolò Battisti, Lorenzo Dottorini, Daris Ferrari, Pasquale Fiduccia, Elena Zafarana, Francesca Del Monte, Francesca Galli, Silvio Monfardini, Paolo Foa
OBJECTIVE: Some parameters of the Comprehensive Geriatric Assessment (CGA) are predictive of chemotherapy toxicity. The Vulnerable Elders Survey-13 (VES-13) is a short instrument that has been tested as a means of identifying patients who need a full CGA, but its ability to predict chemotherapy toxicity is still unclear. We performed a pooled analysis of four published clinical trials studying VES-13 as a means of diagnosing vulnerability, in order to evaluate its accuracy in predicting the risk of grade 3/4 toxicity in older patients undergoing chemotherapy...
July 2015: Journal of Geriatric Oncology
Laércio Lima Luz, Lívia Maria Santiago, João Francisco Santos da Silva, Inês Echenique Mattos
This study aims to assess the psychometric properties of the Brazilian version of the Vulnerable Elders Survey-13 (VES-13). Interviews were carried out with individuals aged 60 years and over receiving care at an ambulatory cancer centre. Test-retest reliability was assessed using the Spearman correlation coefficient, intraclass correlation coefficients and Cohen's kappa coefficient. Construct validity was assessed by testing convergent and discriminant validity using principal component analysis and Varimax rotation...
March 2015: Cadernos de Saúde Pública
Cathy A Maxwell, Lorraine C Mion, Kaushik Mukherjee, Mary S Dietrich, Ann Minnick, Addison May, Richard S Miller
BACKGROUND: Frailty assessment of injured older adults (IOAs) is important for clinical management; however, the feasibility of screening for preinjury frailty has not been established in a Level I trauma center. The aims of our study were to assess enrollment rates of IOAs and their surrogates as well as completion rates of selected brief frailty screening instruments. METHODS: We conducted a prospective cohort study on patients, age 65 years and older with a primary injury diagnosis...
April 2015: Journal of Trauma and Acute Care Surgery
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