Pre-Frailty and Frailty in Hospitalized Older Adults: A Comparison Study in People with and without a History of Cancer in an Acute Medical Unit

A prospective observational study was conducted in a cohort of 329 hospitalized older adults >= 65 years admitted to the acute medical unit (AMU) of a tertiary hospital. Statistical models compared older adults with and without a history of cancer to determine characteristics associated with pre-frailty/frailty and length of hospital stay (LOS). About one-fifth of the cohort had a history of cancer. The prevalence of pre-frailty/frailty among older adults with a history of cancer was 58%. In patients with a history of cancer, pre-frailty/frailty was associated with eight and nine times more likelihood of experiencing polypharmacy and malnutrition, respectively. The risk of having a longer LOS was 24% higher in older adults with a history of cancer than those without. Further investigations are warranted for improvement to systematic assessments to identify those at risk and provide interventions to meet the complex needs of this vulnerable population. A prospective observational study was conducted in a cohort of older adults >= 65 years (n = 329), admitted to the acute medical unit (AMU) of a tertiary hospital, to describe and compare characteristics including frailty status and clinical outcomes. Multivariable models compared older adults with and without a history of cancer to determine characteristics associated with frailty and pre-frailty. An adjusted Poisson regression model was used to compare the length of hospital stay (LOS) between the two groups. About one-fifth (22%) of the cohort had a history of cancer. The most common cancer types were prostate (n = 20), breast (n = 13), lung (n = 8) and gastrointestinal (n = 8). There was no difference in the prevalence of pre-frailty/frailty among patients with or without a history of cancer (58% vs. 57%, p > 0.05). Pre-frailty/frailty was associated with polypharmacy (OR 8.26, 95% CI: 1.74 to 39.2) and malnutrition (OR 8.91, 95% CI: 2.15 to 36.9) in patients with a history of cancer. Adjusted analysis revealed that the risk of having a longer LOS was 24% higher in older adults with a history of cancer than those without (IRR 1.24, 95% CI 1.10 to 1.41, p < 0.001). Clinicians in the AMU should be aware that older adults with a history of cancer have a higher risk of a longer LOS compared to those without.