Technology to Assess Vulnerable Older Adults with Cancer and Their Caregivers

描述（由申请人提供）：本申请的总体目标是利用触摸屏计算机技术从患有癌症的老年人及其照顾者那里获取老年评估信息。老年病学评估涵盖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、营养状况和社会支持。这项评估提供了影响预期寿命的特征的全面概述，并确定了老年人中需要进一步评估或干预的脆弱性领域。这在肿瘤学实践中尤为重要，因为60%的癌症病例和70%的癌症死亡率发生在65岁以下的患者身上。从2010年到2030年，由于美国人口老龄化，预计65岁以下人群的癌症发病率将增加67%，预计将缺乏肿瘤学家和老年病学家来照顾这些老年人。此外，老年人有化疗毒性的风险，老年评估问题可以确定那些有风险的老年人。然而，尽管癌症与衰老、老年肿瘤人群的增长以及老年评估的价值存在关联，但由于时间和资源的需要，这些信息并没有在肿瘤学实践中被常规捕获。技术可以克服这一障碍，以一种有效的方式获取和综合老年评估信息。该建议利用技术将老年病学和肿瘤学领域结合起来。本应用程序的具体目的是：1)确定触摸屏计算机老年评估工具在老年癌症患者及其护理人员中的信度、效度和可行性；2)从患者和护理者的角度理解患者的生理和心理需求。这些目标将由一个具有老年病学、肿瘤学、护理学、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完成。该团队将对100名患者（年龄在100 - 70岁之间，诊断为癌症）及其护理人员进行前瞻性研究，他们将完成触摸屏电脑老年评估工具。这项技术的可行性和患者和护理人员的反应之间的一致性将被评估，包括对预测化疗毒性的老年评估问题的反应。就预期结果而言，目前的项目将通过开发和测试可广泛用于老年癌症患者护理的技术产生积极影响。这项研究也将填补知识的空白，关于护理人员的反应是否与病人的一致。这个提议是创新的，因为它将利用技术来获取和综合老年评估信息，潜在地增加了在繁忙的肿瘤学实践中获取这些信息的可行性。最终，这些数据可以作为将技术整合到老年癌症患者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.