Introduction

Despite an increasing aging population, older adults (≥ 65 years) with primary brain tumors (PBTs) are not routinely assessed for geriatric vulnerabilities. Recent reports of geriatric assessment (GA) in patients with glioblastomas demonstrated that GA may serve as a sensitive prognosticator of overall survival. Yet, current practice does not include routine evaluation of geriatric vulnerabilities and the relevance of GA has not been previously evaluated in broader cohorts of PBT patients. The objective of this descriptive study was to assess key GA constructs in adults with PBT dichotomized into older versus younger groups.

Materials and Methods

A cross-sectional analysis of data collected from 579 participants with PBT recruited between 2016 and 2020, dichotomized into older (≥ 65 years, n = 92) and younger (≤ 64 years, n = 487) from an ongoing observational trial. GA constructs were evaluated using socio-demographic characteristics, Charlson Comorbidity Index (CCI), polypharmacy (>5 daily medications), Karnofsky Performance Status (KPS), Neurologic Function Score (NFS), and patient-reported outcome assessments including general health, functional status, symptom burden and interference, and mood. Descriptive statistics, t-tests, chi-square tests, and Pearson correlations were used to evaluate differences between age groups.

Results

Older participants were more likely to have problems with mobility (58% vs. 44%), usual activities (64% vs 50%) and self-care (38% vs 26%) compared to the younger participants (odds ratios [ORs] = 1.3–1.4, ps < 0.05), while older participants were less likely to report feeling distressed (OR = 0.4, p < 0.05). Older participants also had higher CCI and were more likely to have polypharmacy (OR = 1.7, ps < 0.05). Increasing age strongly correlated with worse KPS score (r = −0.232, OR = 1.4, p < 0.001) and worse NFS (r = 0.210, OR = 1.5, p < 0.001). No differences were observed in overall symptom burden, symptom interference, and anxiety/depression scores.

Discussion

While commonly used GA tools were not available, the study employed patient- and clinician-reported outcomes to identify potential future research directions for the use of GA in the broader neuro-oncology population. Findings illustrate missed opportunities in neuro-oncology practice and underscore the need for incorporation of GA into routine care of this population. Future studies are warranted to further evaluate the prognostic utility of GA and to better understand functional aging outcomes in this patient population.

中文翻译：

---

原发性脑肿瘤人群中关键老年评估结构的评估——一项描述性研究

介绍

尽管人口老龄化不断增加，但患有原发性脑肿瘤 (PBT) 的老年人（≥ 65 岁）并未定期评估其老年脆弱性。最近关于胶质母细胞瘤患者老年评估 (GA) 的报告表明，GA 可以作为总体生存率的敏感预测因子。然而，目前的做法不包括对老年脆弱性的常规评估，并且 GA 的相关性之前没有在更广泛的 PBT 患者队列中进行过评估。这项描述性研究的目的是评估 PBT 成年患者的关键 GA 结构，分为老年组和年轻组。

材料和方法

对从 2016 年至 2020 年间招募的 579 名 PBT 参与者收集的数据进行横断面分析，这些参与者从一项正在进行的观察性试验中分为年龄较大（≥ 65 岁，n  = 92）和年龄较小（≤ 64 岁，n  = 487）。使用社会人口统计学特征、Charlson 合并症指数 (CCI)、多药治疗（>5 种每日药物）、Karnofsky 表现状态 (KPS)、神经功能评分 (NFS) 和患者报告的结果评估，包括一般健康状况、功能状态、症状负担和干扰以及情绪。使用描述性统计、t检验、卡方检验和 Pearson 相关性来评估年龄组之间的差异。

结果

与年轻参与者相比，年长参与者更有可能在行动不便（58% 对 44%）、日常活动（64% 对 50%）和自我照顾（38% 对 26%）方面出现问题（比值比 [ORs] = 1.3–1.4，ps < 0.05），而年长的参与者报告感到痛苦的可能性较小（OR = 0.4，p  < 0.05）。年长的参与者也有更高的 CCI，并且更有可能使用多种药物（OR = 1.7，ps < 0.05）。年龄增长与更差的 KPS 评分（r  = −0.232，OR = 1.4，p  < 0.001）和更差的 NFS（r  = 0.210，OR = 1.5，p  < 0.001）密切相关。在总体症状负担、症状干扰和焦虑/抑郁评分方面未观察到差异。

讨论

虽然常用的 GA 工具不可用，但该研究采用了患者和临床医生报告的结果来确定未来在更广泛的神经肿瘤学人群中使用 GA 的潜在研究方向。研究结果说明了神经肿瘤学实践中错失的机会，并强调需要将 GA 纳入该人群的常规护理。未来的研究有必要进一步评估 GA 的预后效用，并更好地了解该患者人群的功能性衰老结果。