Six independent domains are defined by geriatric assessment in elderly cancer patients☆

Abstract 

Background

Geriatric assessment (GA) must be integrated into treatment concepts for elderly cancer patients. Aim of this study was to assess the coverage of a large battery of GA instruments by determining the number of independent domains measured.

Methods

Thirteen different GA scores were applied in 78 elderly tumor patients (mean age 72.9 years). Data were analyzed by exploratory factor analysis and substantiated by non-parametric correlation analyses.

Results

Factor analysis yielded a six-factor solution explaining 77.1% of the total variance. The six domains identified may be described as general functioning in everyday life, health-related quality of life, co-morbidities, social support, cognition, and nutritional status. This factor structure was reasonably well confirmed by correlation analyses. Notably, WHO Performance Status, Karnofsky Index, VES-13 and PPT generally revealed high correlations with functional capacities, but only low correlations with comorbidities, social support, cognitive functioning or nutritional status.

Conclusions

From the six domains described a basis for efficient application of GA instruments in elderly cancer patients is worked out. The classical instruments WHO and KI as well as the screening scores VES-13 and PPT, while capturing physical functioning well, fail to cover several other important GA domains.

Keywords: Geriatric, Assessment, Elderly, Cancer, Factor analysis, Screening