Frailty, Geriatric Impairments, and Quality of Life in Older Cancer Survivors Compared to Age-Matched Non-Cancer...

Older cancer survivors may experience increased frailty, geriatric impairments, and reduced quality of life, but comparative data from India are scarce. We evaluated these outcomes in long-term survivors versus age-matched controls.

In this case-control study, 62 older cancer survivors (≥60 years) in remission for ≥2 years were recruited from the medical oncology outpatient department (OPD), and age-matched noncancer controls (n = 62) were recruited from a tertiary care hospital in India. Frailty (Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight [FRAIL] scale), depression (Geriatric Depression Scale-15 [GDS-15]), cognitive impairment (Hindi Mental State Examination [HMSE]), impaired mobility (Timed Up and Go test), malnutrition (Mini Nutritional Assessment-short form [MNA-SF]), anxiety (Generalized Anxiety Disorder-7 [GAD-7] questionnaire), fatigue (Fatigue Severity Scale [FSS]), functional status (Katz and Lawton indices), and self-reported sensory impairments were assessed, along with quality of life using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Elderly module (EORTC QLQ-ELD14).

We included 62 older cancer survivors and 62 age-matched controls (median age: 70 years). Frailty was more common in survivors (25.8% vs 9.7%; adjusted odds ratio [OR]: 2.96, 95% confidence interval [CI]: 1.04-8.42). Survivors also had higher prevalence of fatigue (adjusted OR: 7.58), mobility impairment (OR: 3.42), malnutrition (OR: 3.43), mild hearing loss (OR: 4.12), and impaired instrumental activities of daily living (IADLs) and activities of daily living (ADLs). Fatigue and mobility limitations were the most pronounced differences. Mild near-vision and severe distance-vision impairments were significant in some models. Anxiety, depression, and cognitive impairment were not significantly different. Survivors reported worse quality-of-life scores for joint stiffness (OR: 1.03) and purpose in life (OR: 0.98).

Older cancer survivors in India experience higher rates of frailty, specific geriatric impairments, and reduced quality of life than age-matched noncancer controls. These findings highlight the need for integrating geriatric assessment and targeted interventions into survivorship care.