Feasibility of the geriatric assessment in older caregivers of older adults with cancer to guide supportive care.

Authors

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Sindhuja G Kadambi

Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY

Sindhuja G Kadambi, Lisa Stupia, Lu Wang, Jenna Cacciatore, Lee Kehoe, Nikesha Gilmore, Sally Norton, Supriya Gupta Mohile, Allison Magnuson

Organizations

Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, University of Rochester Medical Center, Rochester, NY, University of Rochester, Rochester, NY, Department of Neurobiology and Anatomy, University of Rochester Medical Center, Rochester, NY

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology
Conquer Cancer Foundation of the American Society of Clinical Oncology, Wilmot Cancer Foundation

Background: Older caregivers of older patients with cancer are at high risk for adverse physical and psychological outcomes. Performing a caregiver geriatric assessment (GA) may help identify caregivers at increased risk of adverse outcomes and guide supportive care strategies. In this study, we aimed to determine the feasibility of a GA to evaluate age-related conditions, and physical and emotional health of both patients and caregivers. Methods: Caregivers aged 65+ and patients aged 65+ with diagnosis of cancer receiving a new line of cancer treatment and caregivers aged 65+ were recruited (Goal 60 dyads; current N=40). Patient and caregiver physical and emotional health was captured using the GA which included assessment of physical function (activities of daily living [ADLs], instrumental activities of daily living [IADLs], Short Physical Performance Battery [SPPB], fall history), comorbidity, psychological health (Geriatric Depression Scale [GDS], General Anxiety Disorder-7 [GAD-7]), cognition (Montreal Cognitive Assessment [MOCA] or Blessed Orientation Memory Concentration [BOMC]), Social Support (Older Americans Resources and Services [OARS] Social Support), polypharmacy, nutrition, caregiver Environmental Mastery, and Modified Caregiver Strain Index. Results: Of 40 dyads who have consented, 17 dyads (42%) completed the GA, 14 dyad GAs are pending (35%), eight have withdrawn (20%), and one was lost to follow-up (2.5%). Mean time for caregivers to complete self-reported GA assessment was 47 minutes (range 20-120 minutes) and return to study staff was 5 days (range 0-22 days). Caregivers had mean age 78 years (range 65-85), 100% white, 94% female, and 94% spouses. Caregivers had high prevalence of age-related conditions, including comorbidities (mean 3.7), impairments in ADLs (24%), IADLs (31%), and physical function (55%). More patients than caregivers screened positive for depression (29% vs 12%) and anxiety (17% vs 6%). Caregivers reported high mastery (Ryff subscale, mean 38, range 26-49) and low strain (4.4, range 0-16). Conclusions: The GA is feasible to use in older cancer caregivers to help identify aging related conditions that may influence caregiving ability. Future work should identify how GA in older cancer caregivers can be used to identify intervention strategies to optimize caregiving abilities and improve outcomes in both older adults with cancer and their caregivers. Clinical trial information: NCT05244915.

Patient and caregiver GA characteristics.
GA Domain/ToolPatient % Impaired (N=17)Caregiver % Impaired (N=17)
FunctionADL56%24%
IADL53%31%
Physical PerformanceSPPB73%55%
Falls47%24%
CognitionBOMC/MOCA29% (N=15)17% (N=12)
Psychological statusGDS29%12%
GAD-717%5.9%
Polypharmacy≥5 medications53%82%
Weight loss53%18%

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Health Care Access, Equity, and Disparities,Technology and Innovation in Quality of Care,Palliative and Supportive Care

Sub Track

Caregivers

Clinical Trial Registration Number

NCT05244915

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 224)

DOI

10.1200/OP.2023.19.11_suppl.224

Abstract #

224

Poster Bd #

G5

Abstract Disclosures

Funded by Conquer Cancer

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