Which better predicts mortality among older men, a prostate cancer (PCa) diagnosis or vulnerability on the Vulnerable Elders Survey (VES-13)? A retrospective cohort study

Abstract Objectives Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elde...

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Published in:Journal of geriatric oncology 2016-11, Vol.7 (6), p.437-443
Main Authors: Lowenstein, Lisa M, Mohile, Supriya G, Gil, Heather Hopkins, Pandya, Chintan, Hemmerich, Joshua, Rodin, Miriam, Dale, William
Format: Article
Language:English
Subjects:
Aged
Analysis of Variance
Case-Control Studies
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods
Health Status
Hematology, Oncology and Palliative Medicine
Humans
Internal Medicine
Kaplan-Meier Estimate
Male
Mortality
Prostate cancer
Prostatic Neoplasms - mortality
Retrospective Studies
Surveys and Questionnaires
Vulnerability
Vulnerable Populations - statistics & numerical data
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cited_by cdi_FETCH-LOGICAL-c506t-6af5d508995fe3aa960e9c40193e6f4a7f9102964892ff05dee90928cfb329e63
cites cdi_FETCH-LOGICAL-c506t-6af5d508995fe3aa960e9c40193e6f4a7f9102964892ff05dee90928cfb329e63
container_end_page 443
container_issue 6
container_start_page 437
container_title Journal of geriatric oncology
container_volume 7
creator Lowenstein, Lisa M
Mohile, Supriya G
Gil, Heather Hopkins
Pandya, Chintan
Hemmerich, Joshua
Rodin, Miriam
Dale, William
description Abstract Objectives Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elders Survey (VES-13) for mortality in older men with a PCa diagnosis as compared to controls. Materials and Methods Men aged ≥ 65 years from an urban geriatrics clinic completed the VES-13 between 2003 and 2008. Each patient with a PCa diagnosis was matched by age to five controls, resulting in 59 patients with a PCa diagnosis and 318 controls. Cox proportional hazard models were used to determine the association of a PCa diagnosis and vulnerability on the VES-13 with mortality. Results and Conclusions The mean age for men with a PCa diagnosis and controls was 77.9 years and 76.1 years, respectively. Of those with a PCa diagnosis, 74.6% had no active disease or a rising PSA only. Regardless of PCa diagnosis, vulnerable individuals on the VES-13 were more likely to die during the study period (VES-13 ≥ 3: HR = 4.46, p < 0.01; VES13 ≥ 6: HR = 3.77, p < 0.01). Men with a PCa diagnosis were not more likely to die compared to age-matched controls (VES-13 ≥ 3: HR = 1.14, p = 0.59; VES13 ≥ 6: HR = 1.06, p = 0.83). Vulnerability for men with a PCa diagnosis was more predictive of mortality. Therefore, the assessment of vulnerability is important for establishing goals of care.
doi_str_mv 10.1016/j.jgo.2016.07.011
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A retrospective cohort study</title><source>ScienceDirect Freedom Collection</source><creator>Lowenstein, Lisa M ; Mohile, Supriya G ; Gil, Heather Hopkins ; Pandya, Chintan ; Hemmerich, Joshua ; Rodin, Miriam ; Dale, William</creator><creatorcontrib>Lowenstein, Lisa M ; Mohile, Supriya G ; Gil, Heather Hopkins ; Pandya, Chintan ; Hemmerich, Joshua ; Rodin, Miriam ; Dale, William</creatorcontrib><description>Abstract Objectives Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elders Survey (VES-13) for mortality in older men with a PCa diagnosis as compared to controls. Materials and Methods Men aged ≥ 65 years from an urban geriatrics clinic completed the VES-13 between 2003 and 2008. Each patient with a PCa diagnosis was matched by age to five controls, resulting in 59 patients with a PCa diagnosis and 318 controls. Cox proportional hazard models were used to determine the association of a PCa diagnosis and vulnerability on the VES-13 with mortality. Results and Conclusions The mean age for men with a PCa diagnosis and controls was 77.9 years and 76.1 years, respectively. Of those with a PCa diagnosis, 74.6% had no active disease or a rising PSA only. Regardless of PCa diagnosis, vulnerable individuals on the VES-13 were more likely to die during the study period (VES-13 ≥ 3: HR = 4.46, p &lt; 0.01; VES13 ≥ 6: HR = 3.77, p &lt; 0.01). Men with a PCa diagnosis were not more likely to die compared to age-matched controls (VES-13 ≥ 3: HR = 1.14, p = 0.59; VES13 ≥ 6: HR = 1.06, p = 0.83). Vulnerability for men with a PCa diagnosis was more predictive of mortality. Therefore, the assessment of vulnerability is important for establishing goals of care.</description><identifier>ISSN: 1879-4068</identifier><identifier>EISSN: 1879-4076</identifier><identifier>DOI: 10.1016/j.jgo.2016.07.011</identifier><identifier>PMID: 27480793</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Aged ; Analysis of Variance ; Case-Control Studies ; Frail Elderly - statistics &amp; numerical data ; Geriatric Assessment - methods ; Health Status ; Hematology, Oncology and Palliative Medicine ; Humans ; Internal Medicine ; Kaplan-Meier Estimate ; Male ; Mortality ; Prostate cancer ; Prostatic Neoplasms - mortality ; Retrospective Studies ; Surveys and Questionnaires ; Vulnerability ; Vulnerable Populations - statistics &amp; numerical data</subject><ispartof>Journal of geriatric oncology, 2016-11, Vol.7 (6), p.437-443</ispartof><rights>Elsevier Ltd</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. 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A retrospective cohort study</title><title>Journal of geriatric oncology</title><addtitle>J Geriatr Oncol</addtitle><description>Abstract Objectives Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elders Survey (VES-13) for mortality in older men with a PCa diagnosis as compared to controls. Materials and Methods Men aged ≥ 65 years from an urban geriatrics clinic completed the VES-13 between 2003 and 2008. Each patient with a PCa diagnosis was matched by age to five controls, resulting in 59 patients with a PCa diagnosis and 318 controls. Cox proportional hazard models were used to determine the association of a PCa diagnosis and vulnerability on the VES-13 with mortality. Results and Conclusions The mean age for men with a PCa diagnosis and controls was 77.9 years and 76.1 years, respectively. Of those with a PCa diagnosis, 74.6% had no active disease or a rising PSA only. Regardless of PCa diagnosis, vulnerable individuals on the VES-13 were more likely to die during the study period (VES-13 ≥ 3: HR = 4.46, p &lt; 0.01; VES13 ≥ 6: HR = 3.77, p &lt; 0.01). Men with a PCa diagnosis were not more likely to die compared to age-matched controls (VES-13 ≥ 3: HR = 1.14, p = 0.59; VES13 ≥ 6: HR = 1.06, p = 0.83). Vulnerability for men with a PCa diagnosis was more predictive of mortality. Therefore, the assessment of vulnerability is important for establishing goals of care.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Case-Control Studies</subject><subject>Frail Elderly - statistics &amp; numerical data</subject><subject>Geriatric Assessment - methods</subject><subject>Health Status</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Mortality</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Retrospective Studies</subject><subject>Surveys and Questionnaires</subject><subject>Vulnerability</subject><subject>Vulnerable Populations - statistics &amp; numerical data</subject><issn>1879-4068</issn><issn>1879-4076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9Uk1vEzEQXSEQrUp_ABfkYyqRYO-Hdy2kVlUUClIlkAKFm-V4Z7MOu3awvZHyl_iVnSUhAg74YmvmzZvxe5MkLxmdMcr4m81ss3azFJ8zWs4oY0-Sc1aVYprTkj89vXl1llyGsKF4slSIkj9PztIyr2gpsvPk59fW6JasIEbwZOuhNjoG0jsfVWfinqje2TVxXY3pHuxrohDlQlQRiFZWY3jyaa6uSG3U2rpgAnGe7IbOglcr84vDWRJbIA_HYAdkMfIFshz8DvZk8rBYTll2dUNuiYeI9FvQ0eywg2txEhLiUO9fJM8a1QW4PN4XyZd3i8_z99P7j3cf5rf3U11QHqdcNUVd0EqIooFMKcEpCJ1TJjLgTa7KRjCaCp5XIm0aWtQAgoq00s0K9QGeXSTXB97tsOqh1mCjV53cetMrv5dOGfl3xppWrt1OFqwQSIwEkyOBdz8GCFH2JmjoOmXBDUGyKuVlhnONUHaAavx08NCc2jAqR5vlRqLNcrRZ0lKizVjz6s_5ThW_TUXA2wMAUKWdAS-DNoBW1cajrrJ25r_01_9U685Yo1X3HfYQNm7wFuWXTIZUUrkc92xcM8Yzyij9lj0CXlbQJw</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Lowenstein, Lisa M</creator><creator>Mohile, Supriya G</creator><creator>Gil, Heather Hopkins</creator><creator>Pandya, Chintan</creator><creator>Hemmerich, Joshua</creator><creator>Rodin, Miriam</creator><creator>Dale, William</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161101</creationdate><title>Which better predicts mortality among older men, a prostate cancer (PCa) diagnosis or vulnerability on the Vulnerable Elders Survey (VES-13)? 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A retrospective cohort study</atitle><jtitle>Journal of geriatric oncology</jtitle><addtitle>J Geriatr Oncol</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>7</volume><issue>6</issue><spage>437</spage><epage>443</epage><pages>437-443</pages><issn>1879-4068</issn><eissn>1879-4076</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>Passed away</notes><notes>Present Address: Department of Health Services Research, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Pickens Tower, 1400 Pressler Street, Houston, TX, 77030, USA, lmlowenstein@mdanderson.org</notes><abstract>Abstract Objectives Older men with a prostate cancer (PCa) diagnosis face competing mortality risks. Little is known about the prevalence of vulnerability and predictors of mortality in this population compared to men without a PCa diagnosis. We examined the predictive utility of the Vulnerable Elders Survey (VES-13) for mortality in older men with a PCa diagnosis as compared to controls. Materials and Methods Men aged ≥ 65 years from an urban geriatrics clinic completed the VES-13 between 2003 and 2008. Each patient with a PCa diagnosis was matched by age to five controls, resulting in 59 patients with a PCa diagnosis and 318 controls. Cox proportional hazard models were used to determine the association of a PCa diagnosis and vulnerability on the VES-13 with mortality. Results and Conclusions The mean age for men with a PCa diagnosis and controls was 77.9 years and 76.1 years, respectively. Of those with a PCa diagnosis, 74.6% had no active disease or a rising PSA only. Regardless of PCa diagnosis, vulnerable individuals on the VES-13 were more likely to die during the study period (VES-13 ≥ 3: HR = 4.46, p &lt; 0.01; VES13 ≥ 6: HR = 3.77, p &lt; 0.01). Men with a PCa diagnosis were not more likely to die compared to age-matched controls (VES-13 ≥ 3: HR = 1.14, p = 0.59; VES13 ≥ 6: HR = 1.06, p = 0.83). Vulnerability for men with a PCa diagnosis was more predictive of mortality. Therefore, the assessment of vulnerability is important for establishing goals of care.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>27480793</pmid><doi>10.1016/j.jgo.2016.07.011</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Analysis of Variance
Case-Control Studies
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods
Health Status
Hematology, Oncology and Palliative Medicine
Humans
Internal Medicine
Kaplan-Meier Estimate
Male
Mortality
Prostate cancer
Prostatic Neoplasms - mortality
Retrospective Studies
Surveys and Questionnaires
Vulnerability
Vulnerable Populations - statistics & numerical data
title Which better predicts mortality among older men, a prostate cancer (PCa) diagnosis or vulnerability on the Vulnerable Elders Survey (VES-13)? A retrospective cohort study
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