Presented in part at the Annual Meeting of the American Society of Hematology, December 4–8, 2009, New Orleans, Louisiana.
The Feasibility of Inpatient Geriatric Assessment for Older Adults Receiving Induction Chemotherapy for Acute Myelogenous Leukemia
Article first published online: 13 SEP 2011
© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 59, Issue 10, pages 1837–1846, October 2011
How to Cite
Klepin, H. D., Geiger, A. M., Tooze, J. A., Kritchevsky, S. B., Williamson, J. D., Ellis, L. R., Levitan, D., Pardee, T. S., Isom, S. and Powell, B. L. (2011), The Feasibility of Inpatient Geriatric Assessment for Older Adults Receiving Induction Chemotherapy for Acute Myelogenous Leukemia. Journal of the American Geriatrics Society, 59: 1837–1846. doi: 10.1111/j.1532-5415.2011.03614.x
- Issue published online: 18 OCT 2011
- Article first published online: 13 SEP 2011
- Wake Forest University Claude D. Pepper Older Americans Independence Center. Grant Number: P30 AG-021332
- Atlantic Philanthropies
- American Society of Hematology
- John A. Hartford Foundation
- Association of Specialty Professors
- geriatric assessment;
- acute myelogenous leukemia;
- functional status;
To test the feasibility and utility of a bedside geriatric assessment (GA) to detect impairment in multiple geriatric domains in older adults initiating chemotherapy for acute myelogenous leukemia (AML).
Prospective observational cohort study.
Single academic institution.
Individuals aged 60 and older with newly diagnosed AML and planned chemotherapy.
Bedside GA was performed during inpatient exmination for AML. GA measures included the modified Mini-Mental State Examination; Center for Epidemiologic Studies Depression Scale; Distress Thermometer, Pepper Assessment Tool for Disability (includes self- reported activities of daily living (ADLs), instrumental ADLs, and mobility questions); Short Physical Performance Battery (includes timed 4-m walk, chair stands, standing balance); grip strength, and Hematopoietic Cell Transplantation Comorbidity Index.
Of 54 participants (mean age 70.8 ± 6.4) eligible for this analysis, 92.6% completed the entire GA battery (mean time 44.0 ± 14 minutes). The following impairments were detected: cognitive impairment, 31.5%; depression, 38.9%; distress, 53.7%; impairment in ADLs, 48.2%; impaired physical performance, 53.7%; and comorbidity, 46.3%. Most were impaired in one (92.6%) or more (63%) functional domains. For the 38 participants rated as having good performance status according to standard oncologic assessment (Eastern Cooperative Oncology Performance Scale score ≤1), impairments in individual GA measures ranged from 23.7% to 50%. Significant variability in cognitive, emotional, and physical status was detected even after stratification according to tumor biology (cytogenetic risk group classification).
Inpatient GA was feasible and added new information to standard oncology assessment, which may be important for stratifying therapeutic risk in older adults with AML.