Comparison of two frailty screening tools in older women with early breast cancer

Abstract 

Introduction and objectives

We have tested two frailty screening tools (the Barber Questionnaire [BQ] and the Vulnerable Elderly Survey [VES-13]) to select patients who may benefit from Comprehensive Geriatric Assessment (CGA).

Materials and methods

We included women ≥65 years old, diagnosed with early breast cancer at the University General Hospital in Elche. We compared impairment in the BQ score (score <0 vs. >0) and impairment in the VES-13 score (<3 vs. ≥3), with impaired CGA results (<2 scales with deficits vs. ≥2). We evaluated the diagnostic performance of both questionnaires by Area Under Curve [AUC] and analyzed their concordance with CGA scales (intraclass correlation coefficient [ICC]).

Results

Forty-one women were included. The risk of frailty was 41.76%, 29.3%, and 55.7% when evaluated with BQ, VES-13 and CGA, respectively. The correlation between BQ and CGA was fair (ICC=0.672), but between VES-13 and CGA was very good (ICC=0.814). The predictive capacity of the BQ and the VES-13 for detecting frailty risk was intermediate (AUC=0.719) and high (AUC=0.876), respectively.

Conclusions

We propose the use of the VES-13 in older women with early breast cancer and the implementation of CGA when VES-13<3.

Keywords: Frailty, Comprehensive Geriatric Assessment, Early breast cancer