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A pilot study of the Vulnerable Elders Survey-13 (VES-13) as compared to Comprehensive Geriatric Assessment (CGA) to examine geriatric domains in older prostate cancer patients at risk for decline

A pilot study of the Vulnerable Elders Survey-13 (VES-13) as compared to Comprehensive Geriatric Assessment (CGA) to examine geriatric domains in older prostate cancer patients at risk for decline

Journal of Clinical Oncology 24(18_Suppl): 8539-8539

NlmCategory="UNASSIGNED">8539 Background: Impairments in geriatric domains (e.g. function and cognition) adversely affect health outcomes of the elderly. CGA is a key component of the treatment approach for older cancer pts, but is time-consuming. We evaluated the reliability and validity of a brief functionally-based screening tool, the VES-13, in identifying those older prostate cancer (PCa) pts at risk for impairment in the oncology clinic setting. PCa pts aged ≥ 70 yrs treated with androgen ablation followed within the oncology clinics at the University of Chicago were eligible. Pts self-completed VES-13 and CGA at baseline with VES-13 repeated 1 mth later. Physical performance and cognitive assessments were administered by a research assistant. Pts with impairment were offered follow-up in a "standard of care" frail geriatric elders program. Of 36 participating pts, 50% were impaired by VES-13 (score ≥ 3). 62% of pts scored as impaired on ≥ 2 tests within the CGA exhibiting deficits in multiple geriatric domains. The reliability of the VES-13 (comparing baseline to 1 mth scores) was 0.92 (pearsons correlation coefficient). The cut-off point of 3 on the VES-13 had 72.7% sensitivity and 85.7% specificity and was highly predictive in identifying impairment (ROC AUC 0.8977) when compared to the CGA. Pts with a mean score of VES-13 ≥ 3 performed significantly worse on evaluations of Instrumental Activities of Daily Living (measures ability to live independently) (p=.006), physical performance (p=.024), comorbidity (p<.001), numbers of medications (p=.022), and cognition (p=.018). In multivariate analysis, low education remained significant for VES-13 impairment after adjustment for age (p=.039). 50% of pts accepted referral to an off-site multidisciplinary geriatrics clinic. Reasons for refusal included perceived lack of need by the pt and transportation difficulties. Older PCa pts receiving androgen ablation have significant geriatric impairment. The VES-13 screening measure was predictive in identifying impairment when compared to the CGA and demonstrates feasibility for use in the oncology clinic setting. No significant financial relationships to disclose.

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Accession: 057085746

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PMID: 27954057

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