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Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype
Background: to distinguish direct and indirect pathways to frailty phenotype, and quantify associations between two frailty components (i.e., sarcopenia and cachexia) regarding mortality and morbidity in older adults with cancer. Methods: all consecutive older outpatients with cancer were included i...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356550/ https://www.ncbi.nlm.nih.gov/pubmed/32545298 http://dx.doi.org/10.3390/jcm9061826 |
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author | Pamoukdjian, Frederic Laurent, Marie Martinez-Tapia, Claudia Rolland, Yves Paillaud, Elena Canoui-Poitrine, Florence |
author_facet | Pamoukdjian, Frederic Laurent, Marie Martinez-Tapia, Claudia Rolland, Yves Paillaud, Elena Canoui-Poitrine, Florence |
author_sort | Pamoukdjian, Frederic |
collection | PubMed |
description | Background: to distinguish direct and indirect pathways to frailty phenotype, and quantify associations between two frailty components (i.e., sarcopenia and cachexia) regarding mortality and morbidity in older adults with cancer. Methods: all consecutive older outpatients with cancer were included in a prospective two-centre cohort study between 2013 and 2017 and had geriatric assessment. We used the frailty phenotype. Sarcopenia and cachexia were built as latent variables by including observed variables related to physical performances and related to nutrition and inflammation respectively. Structural equation modelling was used to distinguish between direct and indirect effects of the frailty parameters on the risk of death (Model 1) and the risk of morbidity (defined by unplanned hospitalization and/or disability and/or a fall; Model 2). The root mean square error of approximation (RMSEA) and the comparative fit index (CFI) were used to assess the model fit. Results: 603 older outpatients were included (mean age: 81.2 ± 6.1; women: 54%; frailty phenotype: 58%). The 6-month mortality and morbidity rates were 18% and 64%, respectively. The fit was good for both models (RMSEA and CFI = 0.029 [0.017–0.039] and 0.99 for Model 1, and 0.028 [0.017–0.039] and 0.99 for Model 2, respectively). Sarcopenia and cachexia were both directly and significantly associated with 6-month mortality (β(sarcopenia) = 0.18, p = 0.01; β(cachexia) = 0.52, p < 0.0001) and morbidity (β(sarcopenia) = 0.37, p < 0.0001; β(cachexia) = 0.19, p < 0.02). Conclusions: sarcopenia and cachexia had a direct pathway with 6-month mortality and morbidity in older cancer patients. |
format | Online Article Text |
id | pubmed-7356550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73565502020-07-30 Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype Pamoukdjian, Frederic Laurent, Marie Martinez-Tapia, Claudia Rolland, Yves Paillaud, Elena Canoui-Poitrine, Florence J Clin Med Article Background: to distinguish direct and indirect pathways to frailty phenotype, and quantify associations between two frailty components (i.e., sarcopenia and cachexia) regarding mortality and morbidity in older adults with cancer. Methods: all consecutive older outpatients with cancer were included in a prospective two-centre cohort study between 2013 and 2017 and had geriatric assessment. We used the frailty phenotype. Sarcopenia and cachexia were built as latent variables by including observed variables related to physical performances and related to nutrition and inflammation respectively. Structural equation modelling was used to distinguish between direct and indirect effects of the frailty parameters on the risk of death (Model 1) and the risk of morbidity (defined by unplanned hospitalization and/or disability and/or a fall; Model 2). The root mean square error of approximation (RMSEA) and the comparative fit index (CFI) were used to assess the model fit. Results: 603 older outpatients were included (mean age: 81.2 ± 6.1; women: 54%; frailty phenotype: 58%). The 6-month mortality and morbidity rates were 18% and 64%, respectively. The fit was good for both models (RMSEA and CFI = 0.029 [0.017–0.039] and 0.99 for Model 1, and 0.028 [0.017–0.039] and 0.99 for Model 2, respectively). Sarcopenia and cachexia were both directly and significantly associated with 6-month mortality (β(sarcopenia) = 0.18, p = 0.01; β(cachexia) = 0.52, p < 0.0001) and morbidity (β(sarcopenia) = 0.37, p < 0.0001; β(cachexia) = 0.19, p < 0.02). Conclusions: sarcopenia and cachexia had a direct pathway with 6-month mortality and morbidity in older cancer patients. MDPI 2020-06-11 /pmc/articles/PMC7356550/ /pubmed/32545298 http://dx.doi.org/10.3390/jcm9061826 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Pamoukdjian, Frederic Laurent, Marie Martinez-Tapia, Claudia Rolland, Yves Paillaud, Elena Canoui-Poitrine, Florence Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title | Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title_full | Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title_fullStr | Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title_full_unstemmed | Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title_short | Frailty Parameters, Morbidity and Mortality in Older Adults with Cancer: A Structural Equation Modelling Approach Based on the Fried Phenotype |
title_sort | frailty parameters, morbidity and mortality in older adults with cancer: a structural equation modelling approach based on the fried phenotype |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356550/ https://www.ncbi.nlm.nih.gov/pubmed/32545298 http://dx.doi.org/10.3390/jcm9061826 |
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