Need for Dynamic Frailty Risk Assessment Among Older Adults with Multiple Myeloma: A Population-Based Cohort Study
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171 Need for Dynamic Frailty Risk Assessment Among Older Adults with Multiple Myeloma: A Population-Based Cohort Study
Program: Oral and Poster Abstracts
Type: Oral
Session: 905. Outcomes Research—Lymphoid Malignancies: Health Outcomes in Plasma Cell Disorders and Transplant
Hematology Disease Topics & Pathways:
Research, Clinical Research, health outcomes research, Diseases, real-world evidence, Lymphoid Malignancies
Saturday, December 10, 2022: 12:30 PM
Hira S Mian, MD, MSc1, Tanya Wildes, MD, MSc2, Ravi Vij, MD, MBBS3,4, Ajay Major, MD, MBA5 and Mark A Fiala, PhD6*
1Department of Oncology, McMaster University, Hamilton, ON, Canada
2University of Nebraska Medical Center, Omaha, NE
3Division of Oncology, Department of Medicine, Washington University School of Medicine, Saint Louis, MO
4Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
5University of Colorado School of Medicine, Denver, CO
6Department of Medicine, Division of Hematology & Oncology, Washington University School of Medicine, St. Louis, MO
Introduction
Multiple myeloma (MM) is a cancer of older adults with significant morbidity and mortality. Frail patients are a high-risk subgroup at risk for poor outcomes. While a number of tools have been developed for frailty assessment, many are measured only at baseline and do not take into account changes in frailty over time. Understanding both improvements and deteriorations in frailty over the disease trajectory may have important considerations in modifying treatment delivery based upon a patient’s changing fitness status.
Electronic frailty indices using a cumulative deficit approach have emerged as an important tool for identifying frail older adults in clinical practice through the electronic medical record. A cumulative deficit approach allows for characterization of frailty by evaluating an individual’s health status as a proportion of ageing-associated deficits an individual has incurred. This approach may allow for a more dynamic measurement of frailty as ‘deficits’ may drop off when not actively coded or new 'deficits' may accumulate with increasing co-morbidities. Using an administrative database and the cumulative deficit approach to categorizing frailty, we aimed to 1) evaluate the dynamic trajectory of frailty among a cohort of older adults with MM during the first three years following diagnosis 2) identify factors associated with improvements or deterioration of frailty over time.
