- •This study analyzed the risk factors of frailty in older adults with lung cancer receiving anti-cancer medications including age, fatigue-related symptom cluster, depression, nutrition, D-dimer, Alb, comorbidity, and disease course.
- •By assigning different weights to those risk factors, the prediction model is displayed using a nomogram.
- •The risk prediction model has a good predictive performance. Base on it, health-care workers can monitor frailty risk regularly and conduct personalized preventive interventions.
We aimed to construct and internally validate a frailty risk prediction model in older adults with lung cancer.
In total, 538 patients were recruited in a grade A tertiary cancer hospital in Tianjin, and patients were randomly divided into the training group (n = 377) and the testing group (n = 166) at a ratio of 7:3. The Frailty Phenotype scale was used to identify frailty and logistic regression analysis was used to identify the risk factors and establish a frailty risk prediction model.
In the training group, logistic regression showed that age, fatigue-related symptom cluster, depression, nutritional status, D-dimer level, albumin level, presence of comorbidities, and disease course were independent risk factors for frailty. The areas under the curve (AUCs) of the training and testing groups were 0.921 and 0.872, respectively. A calibration curve of P = 0.447 validated model calibration. The decision curve analysis demonstrated greater clinical benefit when the threshold probability was >20%.
The prediction model had a favorable prediction power for determining the risk of frailty, contributing to the prevention and screening of frailty. Patients with a frailty risk score of more than 0.374 should be regularly monitored for frailty and receive personalized preventive interventions.
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- Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries.Lancet (London, England). 2018; 391: 1023-1075https://doi.org/10.1016/s0140-6736(17)33326-3
- Periodontal Disease and Grip Strength Among Older Adults. vol. 5. 2020https://doi.org/10.3390/geriatrics5030046 (Geriatrics (Basel, Switzerland))
- Cancer-associated cachexia.Nat. Rev. Dis. Prim. 2018; 417105https://doi.org/10.1038/nrdp.2017.105
- Cancer prevention and control: alarming challenges in China.Natl. Sci. Rev. 2016; 3: 117-127https://doi.org/10.1093/nsr/nwv054
- ESPEN guidelines on definitions and terminology of clinical nutrition.Clin. Nutr. 2017; 36: 49-64https://doi.org/10.1016/j.clnu.2016.09.004
- Frailty in older persons.Clin. Geriatr. Med. 2017; 33: 293-303https://doi.org/10.1016/j.cger.2017.02.002
- Effects of elastic band exercise on the frailty states in pre-frail elderly people.Physiother. Theor. Pract. 2020; 36: 1000-1008https://doi.org/10.1080/09593985.2018.1548673
- Cancer statistics in China, 2015.CA A Cancer J. Clin. 2016; 66: 115-132https://doi.org/10.3322/caac.21338
- Adverse health effects of frailty: systematic review and meta-analysis of middle-aged and older adults with implications for evidence-based practice.Worldviews Evidence-Based Nurs. 2021; 18: 282-289https://doi.org/10.1111/wvn.12508
- Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory.Cancer. 2000; 89: 1634-1646https://doi.org/10.1002/1097-0142(20001001)89:7<1634::aid-cncr29>3.0.co;2-v
- Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD Statement.BMC Med. 2015; 13: 1https://doi.org/10.1186/s12916-014-0241-z
- Impacts of frailty on prognosis in lung cancer patients: a systematic review and meta-analysis.Front. Med. 2021; 8715513https://doi.org/10.3389/fmed.2021.715513
- Frailty markers and treatment decisions in patients seen in oncogeriatric clinics: results from the ASRO pilot study.PLoS One. 2016; 11e0149732https://doi.org/10.1371/journal.pone.0149732
- Malnutrition and depression as predictors for 30-day unplanned readmission in older patient: a prospective cohort study to develop 7-point scoring system.BMC Geriatr. 2021; 21: 256https://doi.org/10.1186/s12877-021-02198-7
- Frailty in older adults: evidence for a phenotype.J. Gerontol. Series A, Biol. Sci. Med. Sci. 2001; 56: M146-M156https://doi.org/10.1093/gerona/56.3.m146
- Towards an integral conceptual model of frailty.J. Nutr. Health Aging. 2010; 14: 175-181https://doi.org/10.1007/s12603-010-0045-6
- WDHD1 leads to cisplatin resistance by promoting MAPRE2 ubiquitination in lung adenocarcinoma.Front. Oncol. 2020; 10: 461https://doi.org/10.3389/fonc.2020.00461
- The effect of a geriatric evaluation on treatment decisions and outcome for older cancer patients - a systematic review.Journal of geriatric oncology. 2018; 9: 430-440https://doi.org/10.1016/j.jgo.2018.03.014
- Review of frailty measurement of older people: evaluation of the conceptualization, included domains, psychometric properties, and applicability.Aging Med. (Milton (N.S.W)). 2021; 4: 272-291https://doi.org/10.1002/agm2.12177
- The interrelationship between grip work, self-perceived fatigue and pre-frailty in community-dwelling octogenarians.Exp. Gerontol. 2021; 152111440https://doi.org/10.1016/j.exger.2021.111440
- Health-related and sociodemographic factors associated with physical frailty among older cancer survivors.Journal of geriatric oncology. 2021; 12: 96-101https://doi.org/10.1016/j.jgo.2020.04.015
- Frailty in patients with lung cancer: a systematic review and meta-analysis.Chest. 2022; 162: 485-497https://doi.org/10.1016/j.chest.2022.02.027
- Age-adjusted Charlson comorbidity score is associated with treatment decisions and clinical outcomes for patients undergoing radical cystectomy for bladder cancer.Cancer. 2008; 112: 2384-2392https://doi.org/10.1002/cncr.23462
- Validity of the international physical activity questionnaire Short form (IPAQ-SF): a systematic review.Int. J. Behav. Nutr. Phys. Activ. 2011; 8: 115https://doi.org/10.1186/1479-5868-8-115
- Geriatric assessment-driven intervention (GAIN) on chemotherapy-related toxic effects in older adults with cancer: a randomized clinical trial.JAMA Oncol. 2021; 7e214158https://doi.org/10.1001/jamaoncol.2021.4158
- Barthel index of activities of daily living item response theory analysis of ratings for long-term care residents.Nurs. Res. 2015; 64: 88-99https://doi.org/10.1097/NNR.0000000000000072
- Elevated serum IL-6 and adiponectin levels are associated with frailty and physical function in Chinese older adults.Clin. Interv. Aging. 2018; 13: 2013-2020https://doi.org/10.2147/CIA.S180934
- Evaluation of clinical methods for rating dyspnea.Chest. 1988; 93: 580-586https://doi.org/10.1378/chest.93.3.580
- Functional evaluation: the Barthel index.Md. State Med. J. 1965; 14 (PMID: 14258950): 61-65
- Low-grade inflammation, diet composition and health: current research evidence and its translation.Br. J. Nutr. 2015; 114: 999-1012https://doi.org/10.1017/s0007114515002093
- Prognosis and prognostic research: what, why, and how?.BMJ. 2009; 338: b375https://doi.org/10.1136/bmj.b375
- Validating the Geriatric Depression Scale with proxy-based data: a case-control psychological autopsy study in rural China.J. Affect. Disord. 2018; 241: 533-538https://doi.org/10.1016/j.jad.2018.08.066
- Impact of the comprehensive geriatric assessment on treatment decision in geriatric oncology.BMC Cancer. 2020; 20: 384https://doi.org/10.1186/s12885-020-06878-2
- Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA A Cancer J. Clin. 2021; 71: 209-249https://doi.org/10.3322/caac.21660
- Relationship between frailty and fatigue in older cancer patients.Semin. Oncol. Nurs. 2021; 37151179https://doi.org/10.1016/j.soncn.2021.151179
- Efficacy and safety of anlotinib with and without EGFR-TKIs or immunotherapy in the treatment of elder patients with non-small-cell lung cancer: a retrospective study.BMC Pulm. Med. 2022; 22: 179https://doi.org/10.1186/s12890-022-01981-5
Accepted: March 10, 2023
Received in revised form: February 18, 2023
Received: December 6, 2022
Publication stageIn Press Accepted Manuscript
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
© 2023 Published by Elsevier Ltd.