Technology to Assess Vulnerable Older Adults with Cancer and Their Caregivers

描述(由申请人提供)：此应用程序的主要目标是利用触摸屏计算机技术来捕获患有癌症的老年人及其照顾者的老年评估信息。老年评估涵盖了预测老年人发病率和死亡率的因素，包括功能状态、合并症、认知、心理状态、营养状态和社会支持。这项评估全面概述了影响预期寿命的特征，并确定了老年人的脆弱领域，建议对这些领域进行进一步的评估或干预。这在肿瘤学实践中尤其重要，因为60%的癌症病例和70%的癌症死亡发生在65岁的患者中。从2010年到2030年，由于美国人口老龄化，65岁人群的癌症发病率预计将增加67%，预计将缺乏肿瘤学家和老年医生来照顾这些老年人。此外，老年人面临化疗毒性的风险，老年评估问题可以确定哪些老年人处于风险之中。然而，尽管癌症与老龄化有关，老年肿瘤学人口的增长，以及老年评估的价值，但由于所需的时间和资源，这些信息在肿瘤学实践中并不是常规获取的。技术可以通过以时间高效的方式捕获和合成老年评估信息来克服这一障碍。这项建议利用技术将老年病学和肿瘤学领域统一起来。此应用程序的具体目标是：1)确定触摸屏计算机老年评估工具在老年癌症患者及其照顾者中的可靠性、有效性和可行性；2)从患者和照顾者的角度了解患者的身体和心理需求。这些目标将由一个拥有老年病学、肿瘤学、护理、心理学、社会工作、信息技术和生物统计学专业知识的多学科团队来实现。该团队将对100名患者(70岁，被诊断为癌症)及其照顾者进行前瞻性研究，他们将完成触摸屏计算机老年评估工具。将评估这项技术的可行性以及患者和照顾者反应之间的一致性，包括对预测化疗毒性的老年评估问题的反应。关于预期结果，目前的项目将产生积极影响，开发和测试可广泛用于老年癌症护理的技术。这项研究还将填补关于照顾者的反应是否与患者的反应一致的知识空白。这项建议是创新的，因为它将利用技术来捕获和合成老年评估信息，潜在地增加了在繁忙的肿瘤学实践中获得这些信息的可行性。最终，这些数据可以作为将技术整合到未来对患有癌症的老年人的临床护理和研究中的基础。

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.