Frailty and its associated factors among older adults with cancer undergoing chemotherapy as outpatients: A cross-sectional study

Abstract

Purpose: Frailty can affect cancer treatment decisions and outcomes. Depression, fatigue, and cognitive impair-ment often experienced by patients with cancer are expected to be associated with frailty. We aimed to identify frailty and its related factors in older adults with cancer undergoing chemotherapy.Methods: We conducted a cross-sectional descriptive study in a Korean urban tertiary hospital. A structured self -report questionnaire was used including frailty and its related variables and measured heart rate variability (HRV). Multinomial logistic regression was performed to identify the factors related to frailty.Results: Data from 124 out of 136 patients with stomach, colorectal, and lung cancers were analyzed. Approx-imately 90% of the participants were in the pre-frail and frail groups. There were significant differences among the three groups in terms of depression (p = 0.006) and HRV (p = 0.041). The factor associated with higher frailty levels was depression across groups (pre-frail odds ratio (OR): 1.31, 95% CI: 1.14-1.51; frail OR: 1.29, 95% CI: 1.11-1.49). However, only deficits observed or commented on by others were retained as factors significantly associated with higher frailty in the pre-frail group (OR: 2.40, 95% CI: 1.40-4.13). In contrast, increased HRV (OR: 0.35, 95% CI: 0.13-0.95) was associated with lower frailty levels in the frail group.Conclusion: It is important to classify older adult patients with cancer into pre-frail and frail groups so that in-terventions can be provided on time. Understanding the characteristics associated with frailty in older adult patients with cancer can positively affect their health-related quality of life and treatment outcomes.