Does frailty modulate the predictive value of performance status in older adults living with cancer?

Background. Cancer treatments are not a one-size-fits-all approach, treatment options are rarely studied in aging individuals, leading to worse outcomes related to increased vulnerability in this group of patients. Aims. Since frailty has shown the ability to modify outcomes, our study aims to assess if frailty modifies the association between performance status and days in bed with mortality risk in older adults with cancer. Methods. Our study is a secondary analysis of the Mexican Health and Aging Study, a cohort with a representative sample of individuals aged 50 years or older, with a baseline assessment in 2001 and follow-up data available for the years 2003, 2012, 2015, 2018 and 2021. We extracted the baseline variables from the main questionnaires, and the next-of-kin questionnaires were employed for information regarding mortality. We used Cox regression and Kaplan‒Meier curves for survival analysis. Results. Our sample was composed of 318 individuals, with a mean age of 68.02 years (± SD 10.78), and 62.57% were women. Cox regression revealed that age was a significant risk factor for mortality in frail patients but not in those with low frailty levels. Discussion. in settings where access to a geriatric assessment is limited or would significantly delay cancer-specific therapies, assessing frailty might improve the accuracy of those available cancer prognostic tools that might underperform in frail older adults. Conclusions. Frailty evaluation improves the assessment of older adults living with cancer.