Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 24 (2), 147-151

No Difference in the Phenotypic Expression of Frailty Among Elderly Patients Recently Diagnosed With Cancer Vs Cancer Free Patients


No Difference in the Phenotypic Expression of Frailty Among Elderly Patients Recently Diagnosed With Cancer Vs Cancer Free Patients

K El Haddad et al. J Nutr Health Aging.


Objectives: To examine frailty determinants differences in patients with a recent diagnosis of cancer compared to non-cancer patients among older adult. Revealing those differences will allow us to individualize the exact frailty management in those patients diagnosed with cancer.

Design: This is an observational cross-sectional, monocentric study.

Setting: Patients were evaluated at the Geriatric Frailty Clinic (GFC), in the Toulouse University Hospital, France, between October 2011 and February 2016.

Participants: 1996 patients aged 65 and older were included (1578 patients without cancer and 418 patients with solid and hematological cancer recently diagnosed).

Measurements: Frailty was established according to the frailty phenotype. The frailty phenotype measures five components of frailty: weight loss, exhaustion, low physical activity, weakness and slow gait. Frailty phenotype was categorized as robust, pre-frail and frail.

Results: In a multinomial logistic regression, cancer, compared to the non-cancer group, is not associated with an increased likelihood of being classified as pre frail (RRR 0.9, 95% CI [0.5 ; 1.6 ], p 0.9) or frail (RRR 1.2, 95% CI [0.7 ; 2.0], p 0.4) rather than robust. When considering each Fried criterion, a significant higher odd of weight loss was observed in older patients with cancer compared to the non-cancer patients (OR 2.3, 95% CI [1.8; 3.0], p <0.001) but no statistically significant differences was found among the four other Fried criteria. Sensitivity analysis on the frailty index showed that cancer was not associated with a higher FI score compared to non-cancer (β 0.002, 95%CI [-0.009; 0.01], p 0.6).

Conclusion: In this real-life study evaluating elderly patients with and without cancer, we didn't confirm our hypothesis, in fact we found that cancer was not associated with frailty severity using both a phenotypic model and a deficit accumulation approach. Cancer may contribute, at least additively, to the development of frailty, like any other comorbidity, rather than a global underlying condition of vulnerability.

Keywords: Geriatric oncology; elderly; frailty index; frailty phenotype.

Conflict of interest statement

All authors declare no conflict of interest

Similar articles

See all similar articles


    1. Hamaker M, Jonker J, de Rooij, et al. Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol. 2012;13(10):e437–44. doi: 10.1016/S1470-2045(12)70259-0. - DOI - PubMed
    1. Ferrucci L, Guralnik JM, Studenski S, et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc. 2004;52:625–634. doi: 10.1111/j.1532-5415.2004.52174.x. - DOI - PubMed
    1. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med. 2011;27:17–26. doi: 10.1016/j.cger.2010.08.008. - DOI - PubMed
    1. van Deudekom FJ, van de Ruitenbeek M, Te Water W, et al. Frailty Index and Frailty Phenotype in elderly patients with cancer. Acta Oncol. 2016;55(5):644–6. doi: 10.3109/0284186X.2015.1096022. - DOI - PubMed
    1. Kirkhus L, Šaltytė Benth J, Grønberg BH, et al. Frailty identified by geriatric assessment is associated with poor functioning, high symptom burden and increased risk of physical decline in older cancer patients: Prospective observational study. Palliat Med. 2019;33(3):312–322. doi: 10.1177/0269216319825972. - DOI - PMC - PubMed

LinkOut - more resources