Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment

Sattar, Schroder; Haase, Kristen; Kuster, S.; Puts, Martine; Spoelstra, Sandra; Bradley, Cara; Wildes, Tanya M.; Alibhai, Shabbir M.H.

doi:10.1007/s00520-020-05619-2

Cited by 40 publications

(36 citation statements)

References 63 publications

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“…1 Older breast cancer survivors are at an increased risk of falls and fall-related injuries due to multiple sequelae of cancer and its treatment. [2][3][4] Chemotherapy-induced peripheral neuropathy causes sensory deficits in the lower extremities, often leading to impaired balance and altered walking patterns in breast cancer survivors. 5,6 Muscle weakness and fatigue are also common deficits that impair mobility and balance.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors

Blackwood

Rybicki

2021

Integr Cancer Ther

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Background: Older breast cancer survivors are at an increased risk of loss of postural balance and accidental falls, however, the ability of clinical mobility measures to predict falls has not been determined. The purpose of this study was to examine the prognostic ability, sensitivity, and specificity to predict accidental falls in measures of gait speed and functional mobility in older breast cancer survivors. Methods: Thirty-four breast cancer survivors 65 years and older performed 3 measures of gait speed (GS) (usual, fast, dual-task) and Timed Up and Go (TUG) (TUG, TUG-Cognitive, TUG-Manual). Follow-up calls were made 3 months after testing to track falls. Results: The area under the curve (AUC) was below 0.5 for all GS measures, indicating poor predictive ability and all GS measures had low sensitivity and specificity to predict falls. All TUG measures had AUC values above 0.5. The cutoff score with the best sensitivity/specificity to predict falls was: TUG-Cognitive = 11.32 seconds, Sens = 0.64, Spec = 0.80; TUG-Manual = 9.84 seconds, Sens = 0.71, Spec = 0.65. Conclusion: When assessing fall risk in older breast cancer survivors, performance on the TUG and TUG-Cognitive are able to predict falls.

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Section: Introductionmentioning

confidence: 99%

Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors

Blackwood

Rybicki

2021

Integr Cancer Ther

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“…The use of ADT is associated with increased risk of falls and fracture in patients with prostate cancer (7,(34)(35)(36). Falls cause substantial morbidity and mortality and lead to a considerable burden on health systems (37). Various factors, including ageing, multiple chronic diseases, life style, malnutrition, and decline in muscle strength and physical function, determine the risks of falls (38)(39)(40).…”

Section: Discussionmentioning

confidence: 99%

Muscle Loss During Androgen Deprivation Therapy Is Associated With Higher Risk of Non-Cancer Mortality in High-Risk Prostate Cancer

et al. 2021

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The changes in body composition are early adverse effects of androgen deprivation therapy (ADT); however, their prognostic impact remains unclear in prostate cancer. This study aimed to evaluate the association between body composition changes and survival in patients with high-risk prostate cancer. We measured the skeletal muscle index (SMI) and total adipose tissue index (TATI) at the L3 vertebral level using computed tomography at baseline and within one year after initiating ADT in 125 patients with high-risk prostate cancer treated with radiotherapy and ADT between 2008 and 2018. Non-cancer mortality predictors were identified using Cox regression models. The median follow-up was 49 months. Patients experienced an average SMI loss of 5.5% over 180 days (95% confidence interval: -7.0 to -4.0; p<0.001) and TATI gain of 12.6% over 180 days (95% confidence interval: 9.0 to 16.2; p<0.001). Body mass index changes were highly and weakly correlated with changes in TATI and SMI, respectively (Spearman ρ for TATI, 0.78, p<0.001; ρ for SMI, 0.27, p=0.003). As a continuous variable, each 1% decrease in SMI was independently associated with a 9% increase in the risk of non-cancer mortality (hazard ratio: 1.09; p=0.007). Moreover, the risk of non-cancer mortality increased 5.6-fold in patients with SMI loss ≥5% compared to those with unchanged SMI (hazard ratio: 5.60; p=0.03). Body mass index and TATI were not associated with non-cancer mortality. Muscle loss during ADT is occult, independent of weight change, and independently associated with increased non-cancer mortality in patients with high-risk prostate cancer.

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“…Other variables that were not included were the circumstances of a fall, time point of a fall, impact of the incidence of falls and fall-related injuries on subsequent cancer treatment and e cacious interventions for fall prevention. 19 Further research on these aspects is therefore highly recommended.…”

Section: Limitationsmentioning

confidence: 99%

“…17 In addition, a fall in older persons with cancer can cause delays or complications in treatment, and can have an impact on the course of the disease, care planning, and prognosis. 18,19 Current literature regarding falls in older patients with cancer relies on a patient population that integrates patients with and without a frailty pro le or doesn't report any data related to a frailty pro le. Robust data regarding falls in older patients with cancer and a frailty pro le are missing.…”

mentioning

confidence: 99%

Incidence of falls and fall-related injuries and their predictive factors in frail older persons with cancer: a multicenter study

Kenis

Decoster

Flamaing

et al. 2022

Preprint

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Background: Falls and fall-related injuries are a major public health problem. Data on falls in older persons with cancer is limited and robust data on falls within those with a frailty profile are missing. The aim of this study is to investigate the incidence and predictive factors for falls and fall-related injuries in frail older persons with cancer. Methods: This study is a secondary data analysis from data previously collected in a large prospective multicenter observational cohort study in older persons with cancer in 22 Belgian hospitals (November 2012-February 2015). Patients ≥70 years with a malignant tumor and a frailty profile based on an abnormal G8 score were included upon treatment decision and evaluated with a Geriatric Assessment (GA). At follow-up, data on falls and fall-related injuries were documented. Results: At baseline 2141 (37.2%) of 5759 included patients reported at least one fall in the past 12 months, 1427 patients (66.7%) sustained an injury. Fall-related data of 3681 patients were available at follow-up and at least one fall was reported by 769 patients (20.9%) at follow-up, of whom 289 (37.6%) fell more than once and a fall-related injury was reported by 484 patients (62.9%). Fear of falling was reported in 47.4% of the patients at baseline and in 55.6% of the patients at follow-up. In multivariable analysis, gender and falls history in the past 12 months were predictive factors for both falls and fall-related injuries at follow-up. Other predictive factors for falls, were risk for depression, cognitive decline, dependency in activities of daily living, fear of falling, and use of professional home care. Conclusion: Given the high number of falls and fall-related injuries and high prevalence of fear of falling, multifactorial falls risk assessment and management programs should be integrated in the care of frail older persons with cancer. Trial registration: B322201215495

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Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment

Cited by 40 publications

References 63 publications

Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors

Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors

Muscle Loss During Androgen Deprivation Therapy Is Associated With Higher Risk of Non-Cancer Mortality in High-Risk Prostate Cancer

Incidence of falls and fall-related injuries and their predictive factors in frail older persons with cancer: a multicenter study

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