Bedside Geriatric Assessment Feasible in Elderly With AML

Adds information to standard oncology assessment in older patients with acute myelogenous leukemia

THURSDAY, Oct. 27 (HealthDay News) -- Inpatient bedside geriatric assessment (GA) is feasible, and is useful for identifying multiple geriatric impairments in elderly patients initiating chemotherapy for acute myelogenous leukemia (AML), according to a study published in the October issue of the Journal of the American Geriatrics Society.

Heidi D. Klepin, M.D., from the Wake Forest University in Winston-Salem, N.C., and colleagues investigated whether a bedside GA was feasible and effective in detecting impairement in multiple geriatric domains among 54 adults (mean age, 70.8 years) initiating chemotherapy for AML. Inpatient, bedside GA during examination for AML included the modified Mini-Mental State Examination, Center for Epidemiologic Studies Depression Scale, Distress Thermometer, Short Physical Performance Battery, Pepper Assessment Tool for Disability (self-reported activities of daily living [ADLs], instrumental ADLs, and mobility questions), grip strength, and Hematopoietic Cell Transplantation Comorbidity Index. The entire GA series was completed in 92.6 percent of the participants.

The investigators found that the patients presented with impairments in the following domains: cognition (31.5 percent), depression (38.9 percent), distress (53.7 percent), ADLs (48.2 percent), physical performance (53.7 percent), and comorbidity (46.3 percent). A total of 92.6 percent of patients showed impairment in one domain, and 63 percent showed multiple domain impairments. Impairments in individual GA measures varied from 23.7 to 50 percent among 38 patients who had good performance status on oncologic assessment. Cognitive, physical, and emotional status varied significantly despite stratification by tumor biology.

"Inpatient GA was feasible and added new information to standard oncology assessment," the authors write.

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