Geriatric Evaluation of Oncological Elderly Patients

Michele      Malaguarnera; Paola   Mariangela   Frazzetto; Ozyalcn      Erdogan; Alessandro      Cappellani; Emanuela      Cataudella; Massimiliano      Berretta

Abstract

Cancer has a high prevalence in older age. The management of cancer in the older aged person is an increasingly common problem. Age may be construed as a progressive loss of stress tolerance, due to decline in functional reserve of multiple organ systems, high prevalence of comorbid conditions, limited socioeconomic support, reduced cognition, and higher prevalence of depression. In the elderly, the comorbidities and physiological changes in the pharmacokinetics reduce the prospective for therapy and suggest the importance of a multidimensional assessment of cancer patients as well as the formulation of predictive models of risk, in order to estimate the life expectancy and tolerance to treatment. The pharmacological changes of age include decreased renal excretion of drugs and increased susceptibility to myelosuppression, mucositis, cardio toxicity and neurotoxicity. The chemotherapy in patients older than 75 years is very limited. The geriatric assessment is considered a valid tool in geriatric medical. It is important for two main reasons: first of all, for the need to distinguish the features linked to the geriatric syndromes from those ones which are strictly connected to the cancer pathology; secondly, for its potential prognostic value.

Keywords: Activities of daily living (ADL), age, aging, cancer, cancer-related fatigue, chemotherapy, depression scale, elderly, fit, frail, instrumental activities of daily living (IADL), malnutrition, measurement scales, mild cognitive impairment, oldest, old, treatment, undernutrition, unfit.