Background: Frailty in older adults, especially during hospitalisation, is associated with prolonged hospital stay.
Objective: To compare the prevalence, characteristics, and length of stay of pre-frailty and frailty between older adults with and without a cancer diagnosis in an acute medical unit (AMU).
Methods: A cohort of hospitalised older adults ≥65 years (n=329), admitted to the AMU, Flinders Medical Centre, Adelaide, South Australia were recruited. All eligible patients ≥65 years, admitted between February to September 2020 to the AMU were invited to participate in this study within 48 hours of their hospital admission.
Results: In this cohort, 22% hospitalised older adults (n=71) were cancer survivors. Cancer types included prostate (n=20), breast (n=13), lung (n=8), gastrointestinal (n=8), skin (n=6), colorectal (n=5), head and neck (n=2), liver (n=3), ovarian (n=2), others (n=4). Eight patients had metastatic disease. The prevalence of pre-frailty and frailty (58%) within the cancer survivors were similar to those with no history of cancer (57%). Cancer survivors in this cohort had a range and median (IQR) length of stay of 1 to 28 and 3 (2-6) days, respectively. Binary logistic regression analysis suggested that the cancer survivors were more likely to be associated with a higher comorbidity burden (OR: 1.23, 95% CI: 1.03-1.47, P=0.022) and were less likely to be female (OR:0.40, 95% CI: 0.22-0.70, P=0.002) compared to those without a history of cancer. Multinomial logistic regression analysis suggested that compared to those that were robust, older cancer survivors who were pre-frail or frail were significantly more likely to have a higher number of medications (OR:1.24, 95% CI: 1.01-1.53, P=0.038; OR: 1.30, 95% CI: 1.07-1.58).
Conclusion: There is a high prevalence of pre-frailty and frailty amongst hospitalised older adults in the acute medical unit regardless of cancer diagnosis. Older adult cancer survivors that are pre-frail or frail were more likely to experience polypharmacy.