Evidence map›Paper›PMID 36259424›Full record

ArticleJournal of the American Geriatrics Society2022

The epidemiology of preexisting geriatric and palliative conditions in older adults with poor prognosis cancers.

Mazie Tsang, Siqi Gan, W John Boscardin, Melisa L Wong, Louise C Walter, Alexander K Smith

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Mazie TsangDivision of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0003-1215-4210
Siqi GanDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA.
W John BoscardinDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Melisa L WongDivision of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0001-6390-6959
Louise C WalterDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0002-9642-6238
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0002-9276-0861
University of California, San Francisco · USSan Francisco VA Medical Center · US

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2013 to 2026
$19.9M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MELISSA Diane ALDRIDGE · 2020 to 2026
$17.7M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Advancing patient-centered decision making in older adults with lung cancer: Incorporating risk of functional decline into treatment discussionsK76AG064431 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WONG, MELISA L · 2019 to 2023
$1.3M
Mentoring Researchers in Prognosis Research in Alzheimer’s Disease and Related DementiasK24AG068312 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2020 to 2026
$1.2M
ABNORMAL BLOOD PRESSURE HOMEOSTASIS AND FALLS IN OLD AGER01AG006443 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI LIPSITZ, LEWIS A · 1986 to 1988
–
NIA NIH HHS K24 AG068312NIA NIH HHS K76 AG06443NIA NIH HHS K76 AG064431NIA NIH HHS P01 AG066605NIA NIH HHS P30 AG044281NIA NIH HHS T32 AG000212
6 · The paper itself

Abstract

backgroundOlder patients with poor prognosis cancers have complex needs that can benefit from geriatrics and palliative care principles. Because they are not routinely assessed, the prevalence of preexisting geriatric and palliative conditions in this population is unknown.

methodsWe used the nationally representative Health and Retirement Study (HRS) linked with Medicare claims (1998-2016) to identify adults aged ≥65 years diagnosed with poor prognosis cancers (cancers with a median survival ≤1 year). Using the HRS interview before the first Medicare cancer claim, we used survey-weighted descriptive statistics and modified Poisson regression analysis to examine the prevalence of the following clinically significant conditions: functional impairment, difficulty with mobility, falls and injurious falls, social support, cognition, advance care planning, use of pain or sleep medications, and presence of pain or breathlessness.

resultsOf 2105 participants (mean age 76, 53% women, 34% lung cancer, 21% gastrointestinal cancer), the median survival was 9.6 months. Approximately 65% had difficulty climbing stairs (95% CI 63%-67%), 49% had no advance directive (95% CI 45%-54%), 35% lived alone (95% CI 33%-37%), 36% fell in the last 2 years (95% CI 34%-38%), and 32% rated their memory as poor (95% CI 29%-34%). After adjusting for gender, cancer type, and HRS survey time before the first Medicare claim for a poor prognosis cancer, functional impairment and falls were highest among adults aged 85+. Adults aged 65-74 years were less likely to have an advance directive. After adjusting for age, cancer type, and HRS survey time, women had a higher rate of pain and physical impairment. In exploratory analyses, race and socioeconomic status predicted difficulty with mobility and instrumental activities of daily living, living alone, and advance directive completion.

conclusionsDue to a high prevalence across multiple domains, all older adults with poor prognosis cancers should be assessed for geriatric and palliative care conditions.

Indexed as

Activities of Daily LivingNeoplasmsAgedFemaleGeriatric AssessmentHumansMaleMedicarePainPrognosisUnited Statesadvanced cancergeriatric assessmentgeriatric oncologygeriatric syndromesolder adultspalliative carescreening

Identifiers

PMID36259424
PMCPMC9772051
OpenAlexW4306781075

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.