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Support Care Cancer. 2018 Oct;26(10):3563-3570. doi: 10.1007/s00520-018-4212-3. Epub 2018 Apr 28.

Factors associated with falls in older adults with cancer: a validated model from the Cancer and Aging Research Group.

Author information

1
Division of Medical Oncology, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8056, St Louis, MO, 63110, USA. twildes@dom.wustl.edu.
2
University of Rochester Medical Center, Rochester, NY, USA.
3
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
4
City of Hope, Duarte, CA, USA.
5
Duke University, Raleigh, Durham, NC, USA.
6
Upstate University Hospital, Syracuse, NY, USA.
7
Wake Forest University, Wake Forest, NC, USA.
8
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
9
Yale University, New Haven, CT, USA.
10
Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
11
Thomas Jefferson University, Philadelphia, PA, USA.

Abstract

BACKGROUND:

Falls in older adults with cancer are common, yet factors associated with fall-risk are not well-defined and may differ from the general geriatric population. This study aims to develop and validate a model of factors associated with prior falls among older adults with cancer.

METHODS:

In this cross-sectional secondary analysis, two cohorts of patients aged ≥ 65 with cancer were examined to develop and validate a model of factors associated with falls in the prior 6 months. Potential independent variables, including demographic and laboratory data and a geriatric assessment (encompassing comorbidities, functional status, physical performance, medications, and psychosocial status), were identified. A multivariate model was developed in the derivation cohort using an exhaustive modeling approach. The model selected for validation offered a low Akaike Information Criteria value and included dichotomized variables for ease of clinical use. This model was then applied in the validation cohort.

RESULTS:

The development cohort (N = 498) had a mean age of 73 (range 65-91). Nearly one-fifth (18.2%) reported a fall in the prior 6 months. The selected model comprised nine variables involving functional status, objective physical performance, depression, medications, and renal function. The AUC of the model was 0.72 (95% confidence intervals 0.65-0.78). In the validation cohort (N = 250), the prevalence of prior falls was 23.6%. The AUC of the model in the validation cohort was 0.62 (95% confidence intervals 0.51-0.71).

CONCLUSION:

In this study, we developed and validated a model of factors associated with prior falls in older adults with cancer. Future study is needed to examine the utility of such a model in prospectively predicting incident falls.

KEYWORDS:

Accidental falls; Activities of daily living; Geriatric assessment; Neoplasms; Polypharmacy

PMID:
29705872
PMCID:
PMC6117216
[Available on 2019-10-01]
DOI:
10.1007/s00520-018-4212-3
[Indexed for MEDLINE]

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