Technology to Assess Vulnerable Older Adults with Cancer and Their Caregivers

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DESCRIPTION (provided by applicant): The overarching goal of this application is to utilize touchscreen computer technology to capture geriatric assessment information from older adults with cancer and their caregivers. Geriatric assessment covers factors that predict morbidity and mortality in older adults, including functional status, comorbidity, cognition, psychological state nutritional status, and social support. This assessment provides a comprehensive overview of characteristics that affect life expectancy and identifies areas of vulnerability among older adult for which further evaluation or intervention is indicated. This is particularly important in oncoloy practice because 60% of all cancer cases and 70% of cancer mortality occur in patients > age 65. From 2010 to 2030, there is a projected 67% increase in cancer incidence among individuals > age 65 because of the aging of the US population, and there is a projected shortage of oncologists and geriatricians to care for these older adults. Furthermore, older adults are at risk for chemotherapy toxicity and geriatric assessment questions can identify those older individuals who are at risk. However, despite the association of cancer and aging, the growth of the geriatric oncology population, and the value of a geriatric assessment, this information is not routinely captured in oncology practice because of the time and resources required. Technology can overcome this barrier by capturing and synthesizing geriatric assessment information in a time efficient manner. This proposal utilizes technology to unite the fields of geriatrics and oncology. The specific aims of this application are: 1) To determine the reliability, validity, and feasibility of the touchscreen computer Geriatric Assessment Tool among older patients with cancer and their caregivers; and 2) To understand the patient's physical and psychological needs from the patient's and caregiver's perspective. These aims will be accomplished by a multidisciplinary team with expertise in geriatrics, oncology, nursing, psychology, social work, information technology, and biostatistics. The team will perform a prospective study of 100 patients (age > 70 with a diagnosis of cancer) and their caregivers who will complete a touchscreen computer Geriatric Assessment Tool. The feasibility of this technology and concordance between the patient's and caregiver's responses will be evaluated, including responses to geriatric assessment questions which are predictive of chemotherapy toxicity. With regard to expected outcomes, the current project will have a positive impact by developing and testing technology that could be broadly utilized in the care of older adults with cancer. This study will also fill the gap in knowledge regarding whether a caregiver's responses are concordant with the patient's. This proposal is innovative, as it will utilize technology to capture and synthesize geriatric assessment information, potentially increasing the feasibility of obtaining this information in a busy oncology practice. Ultimately these data could serve as the basis for integrating technology into future clinical care and research studies of older adults wit cancer.