244 a Pilot Study: Frailty and Cognitive Impairment in Patients With Keratinocyte Cancer

Abstract

Background Incidence of keratinocyte cancer is increasing, and age-related variations in management pose risk of over and under-treatment [1]. Comorbidities and frailty may predict quality of life, mortality and surgical outcomes [2]. This study investigated patient presentations in those with skin cancer aged ≤ 70-years versus >70-years. Methods Patients attending dermatology skin cancer clinics were recruited over 8 weeks, June-August 2021. Data including comorbidities, Mini Mental State Exam (MMSE) and Rockwood Clinical Frailty Scale were recorded. Chi-square test for binary characteristics were performed. Results 107 patients were interviewed, the younger cohort (n=46) had a frailty scale of very fit (81.8%), well (11.4%), managing well (6.8%), whereas the older cohort (n=61) were very fit (14.8%), well (21.3%), managing well (34.4%), vulnerable (14.8%), mildly frail (4.9%), moderately frail (3.2%) and severely frail (6.6%). The older cohort with confirmed skin cancer were significantly more frail (vulnerable, mild, moderate and severely frail) than those in the same cohort without skin cancer (p = 0.01). The older cohort MMSE ranged from; no cognitive impairment (85.2%), mild (6.6%), moderate (4.9%), and severe (3.3%). The older cohort with confirmed skin cancer had significantly more cognitive impairment (moderate and severe) than those in the same cohort without skin cancer (p = 0.04). Conclusion Patients with higher frailty score and cognitive impairment were more likely to have skin cancer than their age matched counterparts without. This highlights the importance of the two parameters, and may support clinical guidelines to assist with selecting treatment for older patients with keratinocyte cancer. References 1. Garcovich S et al. Skin cancer epidemics in the elderly as an emerging issue in geriatric oncology. Aging and Disease. 2017; 8(5):643–61. 2. Valdatta L et al. FRAIL scale as a predictor of complications and mortality in older patients undergoing reconstructive surgery for non-melanoma skin cancer. Oncology Letters. 2019; 17(1):263–9.