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Sensor-Based Frailty Assessment in Survivors of Childhood Cancer: A Pilot Study

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Abstract

Background

Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which are scalable to large populations.

Objectives

To validate a sensor-based frailty assessment tool in AYA CCS, compare frailty status between CCS and controls, and assess the correlation between frailty and number of CCS comorbidities.

Design, Setting, and Participants

Mean frailty index (MFI) was assessed by a frailty wrist sensor in 32 AYA CCS who were ≥1 year off therapy and in remission. Results were compared with 32 AYA controls without cancer or chronic disease.

Measurements

Frailty assessments with and without a simultaneous cognitive task were performed to obtain MFI. Results were compared between cases and controls using a Student t test, and the number of pre-frail/frail subjects by Chi Square test. The contribution of radiation therapy (RT) exposure to MFI was assessed in a sub-analysis, and the correlation between the number of comorbidities and MFI was measured using the Pearson method.

Results

MFI was strongly correlated with gait speed in AYA CCS. CCS were more likely to be pre-frail than controls without cancer history (p=0.032), and CCS treated with RT were more likely to be pre-frail than CCS not treated with RT (p<0.001). The number of comorbidities was strongly correlated with MFI (ρ=0.65), with a 0.028 increase in MFI for each added condition (p<0.001).

Conclusions

Results from this study support higher risk for frailty among CCS, especially those with multiple comorbidities or who were treated with RT. A wrist-worn sensor-based method is feasible for application in AYA CCS, and provides an opportunity for cost-effective, rapid screening of at-risk AYA CCS who may benefit from early interventions.

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Acknowledgements

The authors would like to thank the patients who participated in this study as well as their families.

Funding

This work was supported by the Texas Children’s Cancer and Hematology Centers.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, USA

    N. J. Krnavek, M. Zahiri, M. Noun & B. Najafi

  2. Department of Pediatrics, Section of Hematology and Oncology, Baylor College of Medicine, Houston, USA

    S. Ajasin, E. C. Arreola, P. J. Lupo & Maria Monica Gramatges

  3. Department of Pediatrics, Feigin Center, Baylor College of Medicine, 1102 Bates St, Suite 1200, Houston, Texas, 77030, USA

    Maria Monica Gramatges

Authors
  1. N. J. Krnavek
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  2. S. Ajasin
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  3. E. C. Arreola
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  4. M. Zahiri
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  5. M. Noun
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  6. P. J. Lupo
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  7. B. Najafi
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  8. Maria Monica Gramatges
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Corresponding author

Correspondence to Maria Monica Gramatges.

Ethics declarations

This study was approved by the Baylor College of Medicine institutional review board, and conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000.

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Conflicts of Interest

None declared by the Authors.

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Krnavek, N.J., Ajasin, S., Arreola, E.C. et al. Sensor-Based Frailty Assessment in Survivors of Childhood Cancer: A Pilot Study. J Frailty Aging 10, 176–181 (2021). https://doi.org/10.14283/jfa.2020.71

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  • DOI: https://doi.org/10.14283/jfa.2020.71

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