Journal of Geriatric Oncology - Volume 7/6 - Supplement 1

A B S T R A C T S

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is known about the prevalence of fall among older cancer

patients presenting for preoperative evaluation, and its

association with other geriatric syndromes and outcomes.

Objectives:

Our study aims to assess the prevalence of

fall among older cancer patients presenting for preoperative

evaluation, and its association with geriatric syndromes and

outcomes. We will also assess the impact of number of falls

on these outcomes.

Methods:

In 2015, all older cancer patients referred to

Memorial Sloan Kettering Cancer Center Geriatrics service for

preoperative evaluation completed comprehensive geriatric

assessment. Patientswere askedwhether they had experienced

a fall during past year and the number of falls (one vs. more

than one fall) . Moreover, patients answered questions on their

activities of daily living (ADL), instrumental activities of daily

living (iADL), and use of assistive devices. Patients also rated

their functional status using Karnofsky Performance Scale.

Results:

Out of 595 patients, 152 (25.54%) reported fall in

the past 12 months. Among fallers, 95 patients (62.9%) had

only one time fall and 56 (37.1%) of them had more than one

time falls. The prevalence of one time fall and more than

one time fall was 16.01% and 9.54% of the total subjects,

respectively. 54.7% of the last falls happened inside and 45.3%

occurred outside home. Falls were more common in females,

non-married, over 80 year old patients and the ones who lived

with others. However, these differences did not reach the

statistical significance. 33.6% of those with no fall had KPS

of 80 or less, compared to 59.6% and 60.7% of those with one

or more than on fall (p<0.001). 17.6% of patients with no fall

were using canes while 27.4% of patients with only one time

fall and 42.9% with multiple falls were using cane (p <0.001).

The rates of inability to do shopping in patients without fall,

with one-time fall, and multiple falls were 8%, 16.1% and

28.6% respectively (p<0.001). Only 1.4% of patients with no

falls reported being limited a lot in dressing while this rate

was 5.3% in one time fall group and 10.7% in patients with

multiple falls (p<0.001). Among those with no fall, one fall, and

more than one fall, the rate of significant limitation outside

home was 10.1%, 21.3%, and 30.4% respectively (p<0.001).

Conclusion:

History of fall is prevalent among older

cancer patients presenting for preoperative evaluation. It is

associated with geriatric syndromes and outcomes. Further

studies are needed to assess the impact of fall history on

surgical recovery and outcomes of older cancer patients.

Disclosure of interest:

None declared

Keywords:

Fall, functional status, preoperative assessment,

surgery

P048

FRACTURES IN OLDER CANCER PATIENTS, A CALL FOR

ACTION

B. Edwards

*, H. Holmes

, P. Khalil

, M. Sun

, H. Valladarez

J. Song

, X. Zhang

Internal Medicine, University of Texas, MD Anderson Cancer

Center,

Medical School, University of Texas,

Biostatistics,

University of Texas, MD Anderson Cancer Center, Houston, USA

Introduction:

More than 60% of cancer patients are over the

age of 65 years and are subject to aging and cancer therapy

related changes. Older adults also have geriatric risk factors

for fractures such as frailty, cognitive impairment (mild

cognitive impairment [MCI] and dementia), and malnutrition-

including vitamin D deficiency.

Objectives:

Retrospective cohort study. To assess incidence

of fractures, and risk factors for fractures in older cancer

patients.

Methods:

Patients underwent comprehensive geriatric

assessments, including cognitive, functional, nutritional,

physical, and comorbidity assessment. Bone density was

tested and vitamin D assayed. Bone densitometry (Discovery

W, Hologic Corp., Marlborough, MA) of the lumbar spine

(L1-L4), total hip and femoral neck was measured. Analysis:

Logistic regression

Results:

We enrolled 192 patients with gastrointestinal,

urologic, breast, lung and gynecologic cancers. The mean age

was 74.5 ± 6.2 years. Low bone mass and/or osteoporosis were

very common, seen in 80% of patients. Twenty six percent

of the patients reported falls in the prior 6 months. Thirty

percent of patients presented dementia, 37% mild cognitive

impairment (MCI), and 39% frailty. Over the following 3 years,

13% of this cohort sustained fractures. Although BMD was

similar in both genders, women were more likely to fracture

than men (18% vs 7%, p=0.02). Vitamin D < 30 ng/ml was

seen in 54% of 155 patients. In multivariate analysis, vitamin

D insufficiency was identified as a risk factor for fractures

(OR=9.59, 95%CI=1.26, 73.21).

Conclusion:

Older cancer patients have a high incidence

of fractures, higher than older patients without cancer. The

proportion of men suffering fractures is higher than in men

who remain cancer free. Low bone mass, osteoporosis and

vitamin D insufficiency are exceedingly common. A greater

awareness of this adverse event should motivate assessment,

vitamin D supplementation, and pharmacologic treatment

for osteoporosis to prevent fractures in older cancer patients.

Prevention of fracture-related disability will afford older

cancer patients a higher quality of life.

Disclosure of interest:

None declared

Keywords:

Fracture, geriatric assessment, geriatric risk

factors

P049

NEUROCOGNITIVE PROFILE IN OLDER CANCER PATIENTS IN

A GERIATRIC CLINIC