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Geriatric assessment as an aide to understanding falls in older adults with cancer

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Abstract

Purpose

In older adults, falls are a common cause of functional decline, institutionalization, and reduced quality of life. This study (1) investigates the prevalence of falls in a large sample of community-dwelling older adults with a cancer diagnosis and (2) evaluates the association of falls with domains of comprehensive geriatric assessment (CGA) that pertain to falls risk.

Methods

Patients completed a CGA that includes a self-reported measure of number of falls in the past 6 months. Summary statistics are used to describe prevalence of falls and associations with hypothesized risk factors using Fisher’s exact tests and multivariable logistic regression.

Results

A total of 1172 patients were enrolled, mean age 73 (65–99), 74 % female, and 89 % Caucasian. Two hundred fifty-six (22 %) reported one or more falls within the last 6 months. Patients with at least one instrumental activities of daily living (IADL) or physical function deficit had more falls as compared those with no deficits identified (p ≤ 0.001). The number of daily medications, comorbidities, Timed Up and Go score >14 s, and poor vision were also associated with increased falls (p ≤ 0.001). Reduced physical function, poor vision, and low performance status had the highest adjusted odds ratio (3.6, 3.4, and 3.0, respectively) for falls.

Conclusions

There is a high prevalence of falls in community-dwelling older patients with a cancer diagnosis. Falls are significantly associated with several measures of geriatric assessment including IADL, physical function, comorbidities, medications, and vision. Timely identification and management of risk factors for falls are important considerations in the care of older cancer patients.

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Acknowledgments

We would like to acknowledge the University Cancer Research Fund of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill, the Center for Aging and Health at the University of North Carolina at Chapel Hill, and the Breast Cancer Research Foundation, New York, NY. Research reported in this publications was partially supported by the National Cancer Institute of the National Institutes of Health under Award Number R25CA116339. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflict of interest

No conflicts of interest reported for any author. We have full control of all primary data and agree to allow the journal to review our data if requested.

Author’s contributions

All authors were substantially involved in the study concept, design, acquisition of data, data analysis and interpretation, and preparation of manuscript. All authors meet the criteria for authorship stated in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, and final approval has been obtained from all authors. All individuals that have contributed significantly to the work have been listed.

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Authors and Affiliations

  1. UNC Lineberger Comprehensive Cancer Center, 450 West Drive, Chapel Hill, NC, 27514, USA

    Grant R. Williams, Allison M. Deal, Kirsten A. Nyrop, Emily J. Guerard, Trevor A. Jolly & Hyman B. Muss

  2. Department of Health Policy and Management, UNC Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, 27599, USA

    Mackenzi Pergolotti

  3. University of North Carolina at Chapel Hill, Physician’s Office Building 170 Manning Drive, 3rd Floor, Campus Box 7305, Chapel Hill, NC, 27599-7305, USA

    Grant R. Williams, Allison M. Deal, Kirsten A. Nyrop, Mackenzi Pergolotti, Emily J. Guerard, Trevor A. Jolly & Hyman B. Muss

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  1. Grant R. Williams
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  2. Allison M. Deal
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Correspondence to Grant R. Williams.

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Williams, G.R., Deal, A.M., Nyrop, K.A. et al. Geriatric assessment as an aide to understanding falls in older adults with cancer. Support Care Cancer 23, 2273–2280 (2015). https://doi.org/10.1007/s00520-014-2598-0

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  • DOI: https://doi.org/10.1007/s00520-014-2598-0

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