Prevalence of comorbidities in elderly cancer patients
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memo https://doi.org/10.1007/s12254-020-00657-2
Prevalence of comorbidities in elderly cancer patients Alfa Wenkstetten-Holub
· Maria Fangmeyer-Binder · Peter Fasching
Received: 13 July 2020 / Accepted: 5 September 2020 © The Author(s) 2020
Summary Comorbidity is common among cancer patients and increases with age. Comorbid conditions potentially affect treatment, therapy outcomes, and survival of people with cancer. This short review aims at presenting the prevalence of comorbidities, to illustrate their impact on elderly persons with cancer and to discuss their assessment. Keywords Prevalence · Comorbidity · Geriatric assessment · Frailty · Dementia
Introduction Is cancer a geriatric syndrome? Cancer disproportionately impacts older adults: approximately 70% of patients with cancer are aged 65 and older [1]. Over the next 20 years the number of patients with cancer over the age of 65 is expected to increase even further [1]. As our population ages, more individuals are affected by chronic conditions, and the impact of comorbidity in older adults with cancer is an area of growing importance. Comorbidity and polypharmacotherapy, which is often necessary as a result, can
complicate cancer treatment and pose competing risks for morbidity and mortality.
Methods To present the prevalence of comorbidity in elderly patients with cancer, a PubMed search of the published English and German literature was undertaken, using the search terms ‘elderly’, ‘cancer’, ‘clinical trial’, ‘prevalence’, ‘comorbidity’ and ‘assessment’, also including manual searches on references in articles on these topics.
Definitions The World Health Organization (WHO) describes ageing populations as those over 60 years of age [3]. But older population groups are extremely heterogeneous with respect of physical and mental capacities. The loss of ability associated with ageing is only loosely related to a person’s chronological age [5]. According to the definition of the German Geriatric Society, patients are defined as “geriatric” either:
A. Wenkstetten-Holub, MD · M. Fangmeyer-Binder, MD · Prof. P. Fasching, MD () Fifth Medical Department of Endocrinology, Rheumatology and Acute Geriatrics, Clinic Ottakring, Montleartstraße 37, 1160 Vienna, Austria [email protected] A. Wenkstetten-Holub, MD [email protected] M. Fangmeyer-Binder, MD [email protected] Prof. P. Fasching, MD Teaching Unit, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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on the basis of a geriatric multimorbidity and a higher age (usually 70 years and older) or very advanced age (80 years and older) and increased vulnerability due to age-related functional limitations and deterioration of the ability to help oneself.
Age alone is not a criterion for defining a geriatric patient. The performance status varies greatly, depending on age, comorbidities and their therapy: this results in a rough assessment of geriatric patients as “robust”, “vulnerable” and “frail” [4]. More ad
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