Frailty indicators and functional status in older patients after colorectal cancer surgery

J Geriatr Oncol. 2014 Jan;5(1):26-32. doi: 10.1016/j.jgo.2013.08.001. Epub 2013 Aug 30.

Abstract

Objectives: The number of older survivors from colorectal cancer is increasing, but little is known regarding long-term consequences of cancer treatment in this patient group. Physical function is an important outcome for older patients, affecting both autonomy and quality of life. We aimed to investigate physical function in older patients with colorectal cancer before and after surgery, and to examine the role of individual frailty indicators as predictors of functional decline.

Material and methods: We present 16-28 months follow-up data of older patients after elective surgery for colorectal cancer. During a home-visit, physical function was evaluated by activities of daily living (ADL), instrumental activities of daily living (IADL), the timed up-and-go (TUG) test, and grip strength. Measurements were compared with those obtained preoperatively using the Wilcoxon signed rank test. Frailty indicators were dichotomized and implemented in logistic regression models to explore their associations to a decline in the physical function scores.

Results: Eighty-four patients were included and the median age was 82 years. There was a significant decrease in ADL (p = 0.04) and IADL scores (p ≤ 0.001) at follow-up. We found no associations between frailty indicators and the risk of decline in physical functioning.

Conclusion: In our population of older patients with surgically treated colorectal cancer, there was a significant decline in ADL- and IADL-scores at follow-up. No change was found in TUG or grip strength, and frailty indicators did not predict decline in physical function.

Keywords: Colorectal cancer; Frailty; Geriatric oncology; Geriatric surgery; Older cancer patients; Physical function.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / physiopathology*
  • Colorectal Neoplasms / surgery
  • Female
  • Frail Elderly*
  • Hand Strength / physiology
  • Humans
  • Male
  • Postoperative Care
  • Postoperative Complications / physiopathology
  • Preoperative Care
  • Prospective Studies